Hepatectomia esquerda ampliada por adenocarcinoma de ducto hepático: relato de caso.

Abstract

INTRODUCTION: Cholangiocarcinoma is a neoplasm that arises in the bile duct. For nonmetastatic or non-locally advanced disease, surgery is curative therapy. The largest number of patients require an (extended) hemihepatectomy, covering the caudate lobe, with en bloc excision of the extrahepatic bile duct and lymphadenectomy of at least six locoregional lymph nodes for staging. To increase the probability of cure, adjuvant chemotherapy with capecitabine is indicated for six months after resection. There is no precise radiological standard for diagnosis, and histopathological or cytological evaluation is essential. However, imaging tests are immensely important and, among them, SpyGlass has been shown to increase diagnostic accuracy. OBJECTIVE AND CASE REPORT: To report the case of a patient with hepatic duct adenocarcinoma, emphasizing the diagnostic, therapeutic and evolutionary aspects. The patient underwent extended left hepatectomy, including segments V, VIII and caudate, associated with intrahepatic bilio-digestive diversion and cholecystectomy, highlighting the multidisciplinary approach and the results obtained. CONCLUSION: Cholangiocarcinoma is aggressive, with a poor prognosis. Surgery associated with chemotherapy and the use of SpyGlass proved to be crucial in the diagnosis and adequate management of this complex neoplasm.