Laparoscopia no estadiamento do Carcinoma do Pâncreas

  • Ana Rita Sapage Aluna do 6º do Curso de Mestrado Integrado em Medicina na Faculdade de Medicina da Universidade do Porto.
  • António Taveira-Gomes Professor Associado Convidado da Faculdade de Medicina da Universidade do Porto Diretor do Serviço de Cirurgia Geral do Hospital Pedro Hispano, Matosinhos

Resumo

Apesar do avanço no estadiamento pré-operatório do adenocarcinoma do pâncreas, cerca de 10-48% dos doentes classificados como potencialmente curáveis pela tomografia computadorizada pré-operatória apresentam doença metastizada que apenas será identificada no momento da cirurgia. O presente trabalho tem como objetivo rever o papel da laparoscopia no estadiamento desta neoplasia. Foi realizada uma pesquisa bibliográfica na base de dados PubMed, com posterior seleção dos artigos mais relevantes. A laparoscopia de estadiamento aumenta a identificação de tumores incuráveis em 10-15% em doentes com tomografia computadorizada pré-operatória e deve continuar a ser utilizada neste processo. A sua acuidade pode ser melhorada com a utilização da ecografia laparoscópica, da citologiaperitoneal e, no futuro, da laparoscopia de fluorescência. A introdução seletiva da laparoscopia no estadiamento de doentes de alto-risco de doença incurável definido pelas variáveis pré-operatórias dimensão do tumor primário, localização no corpo ou na cauda do pâncreas e níveis de antigénio hidrocarbonado 19-9 (CA 19-9) acima de 150 U/ml, pode minimizar cirurgias desnecessárias, com melhor relação custo-benefício comparativamente à sua aplicação sistemática. O estadiamento combinando a tomografia computadorizada, a ecografia endoscópica e a laparoscopia seletiva permite atingir uma elevada taxa de intervenções potencialmente curativas e
selecionar a melhor opção terapêutica nos doentes com tumor irressecável.

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Publicado
2014-06-01
Como Citar
SAPAGE, Ana Rita; TAVEIRA-GOMES, António. Laparoscopia no estadiamento do Carcinoma do Pâncreas. Revista Portuguesa de Cirurgia, [S.l.], n. 29, p. 29-39, jun. 2014. ISSN 2183-1165. Disponível em: <https://revista.spcir.com/index.php/spcir/article/view/386>. Acesso em: 22 nov. 2019.
Secção
Artigos de Revisão