A review of clinical records of patients with GBC at the INCan in the last 10 years was also made. Actually the surgical procedure most accepted is wedge liver resection and lymphadenectomy, because it seems to improve survival. I all alive with a mean follow up of 33 months, with lesions Nevin II five out of 13 are alive and were treated with wedge liver resection or radiotherapy, lesion Nevin III only 4 alive and received radiotherapy. Patients with lesions Nevin IV and V have the poorest prognosis. GBC is a highly lethal disease.
Early diagnosis make possible to perform radical resections and improve survival.
The effectiveness of a mesenteric arterioportal shunt in preventing liver failure after massive hepatic necrosis was evaluated. Of 98 patients who underwent pancreatic or hepatic resection for pancreatobiliary carcinoma between January 1989 and December 1995, six received a mesenteric arterioportal shunt. Clinical and hemodynamic analyses were done retrospectively. One patient in group A and three patients in group B had good arterioportal shunt patency and favorable clinical courses. However, fatal hepatic necrosis after ligation of the HA proper occurred in one patient in group A from small portal flow despite a presumed patent shunt.