RESUMO
We present a woman 34 years old with echinococcosis of intra and extra hepatic biliary ducts including gallbladder. We found alive cysts, dead cysts and fragments of germinative membranes of a complicated cyst in left lobe (I - II) with clinical findings of obstructive jaundice; pain; cholecystitis and great dilation of biliary ducts. We performed left lobectomy, exploration of biliary ducts, transduodenal sphincteroplasty, cholecystectomy. We haven't had complications. We present ultrasound images of the pathologic pieces.
Assuntos
Doenças dos Ductos Biliares/patologia , Equinococose/patologia , Doenças da Vesícula Biliar/patologia , Adulto , Doenças dos Ductos Biliares/diagnóstico por imagem , Doenças dos Ductos Biliares/parasitologia , Doenças dos Ductos Biliares/cirurgia , Colecistectomia , Colecistite/etiologia , Colestase/etiologia , Doenças do Ducto Colédoco/diagnóstico por imagem , Doenças do Ducto Colédoco/parasitologia , Doenças do Ducto Colédoco/patologia , Doenças do Ducto Colédoco/cirurgia , Dilatação Patológica , Equinococose/diagnóstico por imagem , Equinococose/cirurgia , Equinococose Hepática/diagnóstico por imagem , Equinococose Hepática/cirurgia , Feminino , Doenças da Vesícula Biliar/diagnóstico por imagem , Doenças da Vesícula Biliar/parasitologia , Doenças da Vesícula Biliar/cirurgia , Hepatectomia , Humanos , Esfincterotomia Transduodenal , UltrassonografiaRESUMO
An analysis was made on 134 patients with gastric cancer underwent conventional gastrectomy consecutively at Belen Hospital, Trujillo, Peru from 1966 to 1990. The main objective was to determine the influence on prognosis of independent treatment variables and treatment-dependent variables. Gastric cancer patients (78M:56F) had a median age of 58 years (range, 23 to 82 years). The resectability rate was 48%. The operative mortality rate was of 14.2%. The 5-year actuarial survival rate of this series was 16% (33% for curative gastrectomy and 1% for palliative gastrectomy, p < 0.001). Using univariate analysis, the evolution of gastric cancer was related to palpable mass, macroscopic appearance, tumor size, depth of invasion, tumor stage, lymph node involvement, distant metastases, number of lymph node metastases and operative curability, parameters that affected the rate of survival. However the most important prognostic factor was curability, and almost all patients who survived more than five years were among those submitted to curative gastric resection. The clinical course was not related to age, gender, length of history, location of tumor, histologic type and operative procedure. We concluded that the feasibility of a curative resection would be increased and the prognosis probably improved if the carcinoma could be detected at an early stage.