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Experiencia en el tratamiento del colangiocarcinoma en el Hospital General Universitario de Alicante


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Título :
Experiencia en el tratamiento del colangiocarcinoma en el Hospital General Universitario de Alicante
Autor :
Valdivia Villodre, Cristina
Tutor:
Ramia Ángel, José Manuel
Melgar, Paola  
Editor :
Universidad Miguel Hernández de Elche
Departamento:
Departamentos de la UMH::Patología y Cirugía
Fecha de publicación:
2023-05-07
URI :
https://hdl.handle.net/11000/29778
Resumen :
Introducción: el colangiocarcinoma (CCA) representa a un grupo de tumores epiteliales malignos agresivos, asociados a un diagnóstico tardío y un pronóstico desfavorable. Este grupo de tumores puede estar localizado en la vía biliar intrahepática y extrahepática, lo cual implica la realización de di...  Ver más
Introduction: Cholangiocarcinoma gathers a group of aggressive and malignant tumors united by late diagnosis and poor outcomes. Cholangiocarcinoma can be classified anatomically as intrahepatic or extrahepatic, which entails various surgical therapies according to the location of the tumor. Objetive: Assessing whether the survival and outcomes of patients operated on for cholangiocarcinoma in the General Surgery Service of the Dr. Balmis General University Hospital are modified according to the location of the tumor. Methods: Descriptive observational study with a retrospective review of the General Surgery Hospital’s Results: We have studied 52 patients that underwent surgery for CCA. The median age was 68 years, with 34 males (65,4%). The median for Charlson was 6 (5-7). According to location, 23 were intrahepatic (44,3%), twelve hiliar (23,1%), seven extrahepatic biliary tract (13,5%) and ten intrapancreatic biliary tract (19,2%). As per symptoms when diagnosed, thirteen were asymptomatic, mostly CCI (12/14) (p<0,05). Jaundice was exceptional in CCI while was present in 66,6-90% in other locations (p<0,05). No patient with CCI underwent preoperative biliary drainage and around 28,6-80% did in other locations. Major complications were between 21,7% and 60%, according to locations. Twelve patients were readmitted before 90 days after being discharged (23,1%). Ten patients were stage T1 (19,2%), 36 were T2 (69,2%), five were T3 (9,6%) and one was T4 (1,9%). At the moment, only 42,3% are still alive. The median survival was 26 6 months (IC95% 15 – 38 months). Survival in patients with major complications was 1315 months (IC al 95% 0–42 months), lower than those with no major complications 265 months (IC 95% 16–36 months), however, it was not statistically significant (Log Rank p=0.165). When stratified by location no statistically significant difference is found (Log Rank p= 0.436). Local recurrence was between 33,3 and 50% and extra-regional between 10-42.9% according to location, without difference by location. Conclusion: In our CCA series, we have not found survival difference according to tumoral location or complications. Survival in patients with major complications is lower than those without complications, but it does not reach statistically significance. In such a high morbidity and mortality rate surgery this data is important. More multicenter with higher cases studies are necessary to confirm the data obtained. and comparing survival related factors.
Palabras clave/Materias:
cholangiocarcinoma
survival
surgery
malignant hepatic tumor
late diagnosis
Área de conocimiento :
CDU: Ciencias aplicadas: Medicina
Tipo de documento :
info:eu-repo/semantics/bachelorThesis
Derechos de acceso:
info:eu-repo/semantics/openAccess
Aparece en las colecciones:
TFG- Medicina



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