[Central inferior bisegmentectomy (S4B+S5) for gallbladder carcinoma treatment: a series of seven resectable cases].
BACKGROUND
Despite its rarity, gallbladder cancer is an aggressive type of neoplasia with a very poor prognosis. The best resection for oncological purposes continues to be right hepatectomy extended to segment IV. However, bisegmentectomy IV-V is becoming an interesting alternative because of greater preservation of the parenchyma.


OBJECTIVE
To report the early and late results from bisegmentectomy IV-V in cases of carcinoma of the gallbladder.


METHODS
A series of seven cases of invasive carcinoma is presented (six women and one man). These patients underwent bisegmentectomy IV-V at the General Surgery Service of the Teaching Hospital of the ABC Medical School, Santo André, SP, Brazil. The study was conducted between 2002 and 2006. The patients ages ranged from 52 to 72 years. The diagnosis was preoperative (radiological) in five cases, which were all confirmed by intraoperative frozen-tissue examination, while in two cases the diagnosis was postoperative, following open cholecystectomy.


RESULTS
The duration of the operation ranged from 180 to 340 minutes. The quantity of intraoperative bleeding ranged from 200 to 1500 mL. There were two major complications but no mortality. Six patients did not present any recurrence over the course of 3 to 30 months of follow-up.


CONCLUSIONS
Bisegmentectomy IV-V may constitute a curative surgical alternative for treating gallbladder cancer. This procedure presents acceptable morbidity and mortality.
Costa
Sergio Renato Pais
SR
Serviço de Cirurgia Geral, Hospital de Ensino, Disciplina de Cirurgia do Aparelho Digestivo, Faculdade de Medicina do ABC, Santo André, SP, Brasil. sergiorenatopais@terra.com.br
Horta
Sergio Henrique Couto
SH
Miotto
Marcelo José
MJ
Costas
Maurício Campanelli
MC
Godinho
Carlos Alberto
CA
Henriques
Alexandre Cruz
AC
D000368:Aged; D005260:Female; D005500:Follow-Up Studies; D005706:Gallbladder Neoplasms / Q000473:pathology / Q000601:surgery*; D006498:Hepatectomy / Q000379:methods*; D006801:Humans; D008297:Male; D008875:Middle Aged; D009361:Neoplasm Invasiveness; D016896:Treatment Outcome