{"id":3210,"date":"2021-12-03T07:44:47","date_gmt":"2021-12-03T07:44:47","guid":{"rendered":"https:\/\/www.cirurgiahpb.com.br\/?page_id=3210"},"modified":"2023-02-17T13:05:29","modified_gmt":"2023-02-17T13:05:29","slug":"patologias-da-vesicula-vias-biliares","status":"publish","type":"page","link":"https:\/\/www.cirurgiahpb.com.br\/patologias-da-vesicula-vias-biliares\/","title":{"rendered":"Patologias da Ves\u00edcula \/ Vias Biliares"},"content":{"rendered":"\t\t<div data-elementor-type=\"wp-page\" data-elementor-id=\"3210\" class=\"elementor elementor-3210\" data-elementor-post-type=\"page\">\n\t\t\t\t\t\t<section class=\"elementor-section elementor-top-section elementor-element elementor-element-b5ad0b8 elementor-section-boxed elementor-section-height-default elementor-section-height-default\" data-id=\"b5ad0b8\" data-element_type=\"section\">\n\t\t\t\t\t\t<div class=\"elementor-container elementor-column-gap-default\">\n\t\t\t\t\t<div class=\"elementor-column elementor-col-100 elementor-top-column elementor-element elementor-element-570848c\" data-id=\"570848c\" data-element_type=\"column\">\n\t\t\t<div class=\"elementor-widget-wrap\">\n\t\t\t\t\t\t\t<\/div>\n\t\t<\/div>\n\t\t\t\t\t<\/div>\n\t\t<\/section>\n\t\t\t\t<section class=\"elementor-section elementor-top-section elementor-element elementor-element-15d1afd elementor-section-boxed elementor-section-height-default elementor-section-height-default\" data-id=\"15d1afd\" data-element_type=\"section\">\n\t\t\t\t\t\t<div class=\"elementor-container elementor-column-gap-default\">\n\t\t\t\t\t<div class=\"elementor-column elementor-col-33 elementor-top-column elementor-element elementor-element-6836db5\" data-id=\"6836db5\" data-element_type=\"column\">\n\t\t\t<div class=\"elementor-widget-wrap\">\n\t\t\t\t\t\t\t<\/div>\n\t\t<\/div>\n\t\t\t\t<div class=\"elementor-column elementor-col-33 elementor-top-column elementor-element elementor-element-ef62692\" data-id=\"ef62692\" data-element_type=\"column\">\n\t\t\t<div class=\"elementor-widget-wrap elementor-element-populated\">\n\t\t\t\t\t\t<div class=\"elementor-element elementor-element-bd577ec elementor-toc--minimized-on-tablet elementor-widget elementor-widget-table-of-contents\" data-id=\"bd577ec\" data-element_type=\"widget\" data-settings=\"{&quot;headings_by_tags&quot;:[&quot;h2&quot;,&quot;h3&quot;,&quot;h4&quot;],&quot;exclude_headings_by_selector&quot;:[],&quot;marker_view&quot;:&quot;bullets&quot;,&quot;icon&quot;:{&quot;value&quot;:&quot;far fa-circle&quot;,&quot;library&quot;:&quot;fa-regular&quot;},&quot;minimize_box&quot;:&quot;yes&quot;,&quot;minimized_on&quot;:&quot;tablet&quot;,&quot;hierarchical_view&quot;:&quot;yes&quot;,&quot;min_height&quot;:{&quot;unit&quot;:&quot;px&quot;,&quot;size&quot;:&quot;&quot;,&quot;sizes&quot;:[]},&quot;min_height_tablet&quot;:{&quot;unit&quot;:&quot;px&quot;,&quot;size&quot;:&quot;&quot;,&quot;sizes&quot;:[]},&quot;min_height_mobile&quot;:{&quot;unit&quot;:&quot;px&quot;,&quot;size&quot;:&quot;&quot;,&quot;sizes&quot;:[]}}\" data-widget_type=\"table-of-contents.default\">\n\t\t\t\t<div class=\"elementor-widget-container\">\n\t\t\t\t\t<div class=\"elementor-toc__header\">\n\t\t\t<h2 class=\"elementor-toc__header-title\">\n\t\t\t\t\u00cdndice\t\t\t<\/h2>\n\t\t\t\t\t\t\t<div class=\"elementor-toc__toggle-button elementor-toc__toggle-button--expand\" role=\"button\" tabindex=\"0\" aria-controls=\"elementor-toc__bd577ec\" aria-expanded=\"true\" aria-label=\"Open table of contents\"><i aria-hidden=\"true\" class=\"fas fa-chevron-down\"><\/i><\/div>\n\t\t\t\t<div class=\"elementor-toc__toggle-button elementor-toc__toggle-button--collapse\" role=\"button\" tabindex=\"0\" aria-controls=\"elementor-toc__bd577ec\" aria-expanded=\"true\" aria-label=\"Close table of contents\"><i aria-hidden=\"true\" class=\"fas fa-chevron-up\"><\/i><\/div>\n\t\t\t\t\t<\/div>\n\t\t<div id=\"elementor-toc__bd577ec\" class=\"elementor-toc__body\">\n\t\t\t<div class=\"elementor-toc__spinner-container\">\n\t\t\t\t<i class=\"elementor-toc__spinner eicon-animation-spin eicon-loading\" aria-hidden=\"true\"><\/i>\t\t\t<\/div>\n\t\t<\/div>\n\t\t\t\t<\/div>\n\t\t\t\t<\/div>\n\t\t\t\t<div class=\"elementor-element elementor-element-d41e3f4 elementor-widget elementor-widget-spacer\" data-id=\"d41e3f4\" data-element_type=\"widget\" data-widget_type=\"spacer.default\">\n\t\t\t\t<div class=\"elementor-widget-container\">\n\t\t\t\t\t<div class=\"elementor-spacer\">\n\t\t\t<div class=\"elementor-spacer-inner\"><\/div>\n\t\t<\/div>\n\t\t\t\t<\/div>\n\t\t\t\t<\/div>\n\t\t\t\t<div class=\"elementor-element elementor-element-d6d861f elementor-widget elementor-widget-heading\" data-id=\"d6d861f\" data-element_type=\"widget\" data-widget_type=\"heading.default\">\n\t\t\t\t<div class=\"elementor-widget-container\">\n\t\t\t<h2 class=\"elementor-heading-title elementor-size-default\">VES\u00cdCULA BILIAR E VIAS BILIARES  <\/h2>\t\t<\/div>\n\t\t\t\t<\/div>\n\t\t\t\t<div class=\"elementor-element elementor-element-4220328 elementor-widget elementor-widget-text-editor\" data-id=\"4220328\" data-element_type=\"widget\" data-widget_type=\"text-editor.default\">\n\t\t\t\t<div class=\"elementor-widget-container\">\n\t\t\t\t\t\t\t<p><span style=\"font-weight: 400;\">A ves\u00edcula biliar (com sete a dez cent\u00edmetros de comprimento), situa-se na por\u00e7\u00e3o<\/span> <span style=\"font-weight: 400;\">\u00ednfero-anterior do f\u00edgado na jun\u00e7\u00e3o de seus lobos direito e esquerdo. A fun\u00e7\u00e3o da<\/span> <span style=\"font-weight: 400;\">ves\u00edcula biliar \u00e9 o armazenamento de bile.<\/span><span style=\"font-weight: 400;\">\u00a0<\/span><\/p><p><span style=\"font-weight: 400;\">As vias biliares s\u00e3o o conjunto de ductos encarregados de transportar a bile de dentro do f\u00edgado at\u00e9 \u00e0 ves\u00edcula, onde fica armazenada e, posteriormente, segue at\u00e9 ao intestino delgado, onde exerce a sua a\u00e7\u00e3o digestiva. Abrangem, portanto, uma s\u00e9rie de ductos intra-hep\u00e1ticos e outra s\u00e9rie de ductos extra-hep\u00e1ticos, que se encontram dentro e fora do f\u00edgado respectivamente. Ao longo desse caminho, os ductos biliares se comunicam com a ves\u00edcula biliar atrav\u00e9s de um pequeno ducto, o ducto c\u00edstico.\u00a0<\/span><\/p><p><span style=\"font-weight: 400;\">Dito isso, agora podemos entender melhor o que acontece com nosso organismo quando temos algum c\u00e1lculo (pedra) obstrutivo ou tumor no sistema biliar. Ambas as situa\u00e7\u00f5es requerem tratamento por equipe especializada em vias biliares, capaz de identificar o que esta causando a obstru\u00e7\u00e3o do fluxo da bile e qual ser\u00e1 o melhor tratamento proposto.\u00a0<\/span><\/p>\t\t\t\t\t\t<\/div>\n\t\t\t\t<\/div>\n\t\t\t\t<div class=\"elementor-element elementor-element-1abdd1c elementor-widget elementor-widget-spacer\" data-id=\"1abdd1c\" data-element_type=\"widget\" data-widget_type=\"spacer.default\">\n\t\t\t\t<div class=\"elementor-widget-container\">\n\t\t\t\t\t<div class=\"elementor-spacer\">\n\t\t\t<div class=\"elementor-spacer-inner\"><\/div>\n\t\t<\/div>\n\t\t\t\t<\/div>\n\t\t\t\t<\/div>\n\t\t\t\t<div class=\"elementor-element elementor-element-f78ed45 elementor-icon-list--layout-traditional elementor-list-item-link-full_width elementor-widget elementor-widget-icon-list\" data-id=\"f78ed45\" data-element_type=\"widget\" data-widget_type=\"icon-list.default\">\n\t\t\t\t<div class=\"elementor-widget-container\">\n\t\t\t\t\t<ul class=\"elementor-icon-list-items\">\n\t\t\t\t\t\t\t<li class=\"elementor-icon-list-item\">\n\t\t\t\t\t\t\t\t\t\t\t<a href=\"https:\/\/www.cirurgiahpb.com.br\/#vias\">\n\n\t\t\t\t\t\t\t\t\t\t\t\t<span class=\"elementor-icon-list-icon\">\n\t\t\t\t\t\t\t<i aria-hidden=\"true\" class=\"fas fa-arrow-left\"><\/i>\t\t\t\t\t\t<\/span>\n\t\t\t\t\t\t\t\t\t\t<span class=\"elementor-icon-list-text\">Voltar para a p\u00e1gina inicial<\/span>\n\t\t\t\t\t\t\t\t\t\t\t<\/a>\n\t\t\t\t\t\t\t\t\t<\/li>\n\t\t\t\t\t\t<\/ul>\n\t\t\t\t<\/div>\n\t\t\t\t<\/div>\n\t\t\t\t<div class=\"elementor-element elementor-element-212e8eb elementor-widget elementor-widget-menu-anchor\" data-id=\"212e8eb\" data-element_type=\"widget\" data-widget_type=\"menu-anchor.default\">\n\t\t\t\t<div class=\"elementor-widget-container\">\n\t\t\t\t\t<div id=\"colelitiase\" class=\"elementor-menu-anchor\"><\/div>\n\t\t\t\t<\/div>\n\t\t\t\t<\/div>\n\t\t\t\t<div class=\"elementor-element elementor-element-0208216 elementor-widget elementor-widget-heading\" data-id=\"0208216\" data-element_type=\"widget\" data-widget_type=\"heading.default\">\n\t\t\t\t<div class=\"elementor-widget-container\">\n\t\t\t<h2 class=\"elementor-heading-title elementor-size-default\">DOEN\u00c7AS  BENIGNAS<\/h2>\t\t<\/div>\n\t\t\t\t<\/div>\n\t\t\t\t<div class=\"elementor-element elementor-element-cf01fdd elementor-widget elementor-widget-heading\" data-id=\"cf01fdd\" data-element_type=\"widget\" data-widget_type=\"heading.default\">\n\t\t\t\t<div class=\"elementor-widget-container\">\n\t\t\t<h3 class=\"elementor-heading-title elementor-size-default\">Colelit\u00edase (=pedras na ves\u00edcula biliar)<\/h3>\t\t<\/div>\n\t\t\t\t<\/div>\n\t\t\t\t<div class=\"elementor-element elementor-element-f4d3814 elementor-widget elementor-widget-text-editor\" data-id=\"f4d3814\" data-element_type=\"widget\" data-widget_type=\"text-editor.default\">\n\t\t\t\t<div class=\"elementor-widget-container\">\n\t\t\t\t\t\t\t<p><span style=\"font-weight: 400;\">Colelit\u00edase \u00e9 o termo m\u00e9dico que significa a presen\u00e7a de c\u00e1lculos na ves\u00edcula biliar (as chamadas &#8220;pedras na ves\u00edcula&#8221;). <\/span><span style=\"font-weight: 400;\">Cerca de 80% das pessoas com c\u00e1lculos<\/span> <span style=\"font-weight: 400;\">biliares n\u00e3o apresentam sintomas por muitos anos, ou podem nunca t\u00ea-los,<\/span> <span style=\"font-weight: 400;\">especialmente se eles permanecerem na ves\u00edcula biliar, em posi\u00e7\u00e3o que n\u00e3o obstrui<\/span> <span style=\"font-weight: 400;\">o fluxo da bile. <br \/><br \/><\/span><span style=\"font-weight: 400;\">Os c\u00e1lculos podem ser pequenos ou grandes, e podem obstruir a passagem da bile. Dependendo do local da obstru\u00e7\u00e3o podem gerar diferentes sintomas, de uma dor forte conhecida por c\u00f3lica biliar, a uma infec\u00e7\u00e3o na ves\u00edcula biliar ou at\u00e9 mesmo obstru\u00e7\u00e3o da sa\u00edda da bile para o intestino. <br \/><br \/>Os sintomas decorrentes dos c\u00e1lculos biliares localizados dentro da ves\u00edcula biliar s\u00e3o frequentemente chamados de &#8220;crise&#8221; de c\u00f3lica biliar pois ocorrem subitamente. Decorrem habitualmente da obstru\u00e7\u00e3o transit\u00f3ria do canal de sa\u00edda da ves\u00edcula (o ducto c\u00edstico) por um c\u00e1lculo. Um ataque t\u00edpico pode causar: Dor persistente no abdome superior (geralmente do meio para a direita) que aumenta rapidamente de intensidade e dura de 30 minutos a v\u00e1rias horas. Pode ser acompanhada de <\/span><span style=\"font-weight: 400;\">n\u00e1useas e v\u00f4mitos.Os ataques frequentemente se seguem a refei\u00e7\u00f5es gordurosas, e podem ocorrer \u00e0 noite. <br \/><br \/>A colelit\u00edase quando presente em pacientes assintom\u00e1ticos n\u00e3o \u00e9 por si motivo de retirada da ves\u00edcula biliar, apenas quando come\u00e7a a causar sintomas. A partir do momento que causa sintomas existe indica\u00e7\u00e3o de retirada da ves\u00edcula biliar. A cirurgia da retirada da ves\u00edcula \u00e9 realizada por videolaparoscopia em quase totalidade dos casos, \u00e9 chamada de colecistectomia videolaprosc\u00f3pica. <\/span><span style=\"font-weight: 400;\">Ap\u00f3s pequenas incis\u00f5es terem sido feitas no abd\u00f4men, o laparosc\u00f3pio (= c\u00e2mera de<\/span> <span style=\"font-weight: 400;\">v\u00eddeo) \u00e9 inserido. As ferramentas cir\u00fargicas s\u00e3o passadas pelas incis\u00f5es e s\u00e3o<\/span> <span style=\"font-weight: 400;\">usadas para remover a ves\u00edcula biliar. A colecistectomia laparosc\u00f3pica veio diminuir<\/span> <span style=\"font-weight: 400;\">o mal-estar p\u00f3s-operat\u00f3rio, o tempo de interna\u00e7\u00e3o hospitalar, forneceu melhores<\/span> <span style=\"font-weight: 400;\">resultados cosm\u00e9ticos e reduziu o tempo necess\u00e1rio para recupera\u00e7\u00e3o.<\/span><\/p>\t\t\t\t\t\t<\/div>\n\t\t\t\t<\/div>\n\t\t\t\t<div class=\"elementor-element elementor-element-abccd2e elementor-icon-list--layout-traditional elementor-list-item-link-full_width elementor-widget elementor-widget-icon-list\" data-id=\"abccd2e\" data-element_type=\"widget\" data-widget_type=\"icon-list.default\">\n\t\t\t\t<div class=\"elementor-widget-container\">\n\t\t\t\t\t<ul class=\"elementor-icon-list-items\">\n\t\t\t\t\t\t\t<li class=\"elementor-icon-list-item\">\n\t\t\t\t\t\t\t\t\t\t\t<a href=\"https:\/\/www.cirurgiahpb.com.br\/#vias\">\n\n\t\t\t\t\t\t\t\t\t\t\t\t<span class=\"elementor-icon-list-icon\">\n\t\t\t\t\t\t\t<i aria-hidden=\"true\" class=\"fas fa-arrow-left\"><\/i>\t\t\t\t\t\t<\/span>\n\t\t\t\t\t\t\t\t\t\t<span class=\"elementor-icon-list-text\">Voltar para a p\u00e1gina inicial<\/span>\n\t\t\t\t\t\t\t\t\t\t\t<\/a>\n\t\t\t\t\t\t\t\t\t<\/li>\n\t\t\t\t\t\t<\/ul>\n\t\t\t\t<\/div>\n\t\t\t\t<\/div>\n\t\t\t\t<div class=\"elementor-element elementor-element-a4e5df2 elementor-widget elementor-widget-menu-anchor\" data-id=\"a4e5df2\" data-element_type=\"widget\" data-widget_type=\"menu-anchor.default\">\n\t\t\t\t<div class=\"elementor-widget-container\">\n\t\t\t\t\t<div id=\"Coledocolitiase\" class=\"elementor-menu-anchor\"><\/div>\n\t\t\t\t<\/div>\n\t\t\t\t<\/div>\n\t\t\t\t<div class=\"elementor-element elementor-element-8419d57 elementor-widget elementor-widget-spacer\" data-id=\"8419d57\" data-element_type=\"widget\" data-widget_type=\"spacer.default\">\n\t\t\t\t<div class=\"elementor-widget-container\">\n\t\t\t\t\t<div class=\"elementor-spacer\">\n\t\t\t<div class=\"elementor-spacer-inner\"><\/div>\n\t\t<\/div>\n\t\t\t\t<\/div>\n\t\t\t\t<\/div>\n\t\t\t\t<div class=\"elementor-element elementor-element-a0e26f1 elementor-widget elementor-widget-heading\" data-id=\"a0e26f1\" data-element_type=\"widget\" data-widget_type=\"heading.default\">\n\t\t\t\t<div class=\"elementor-widget-container\">\n\t\t\t<h3 class=\"elementor-heading-title elementor-size-default\">Coledocolitiase (=pedras no canal biliar) \n<\/h3>\t\t<\/div>\n\t\t\t\t<\/div>\n\t\t\t\t<div class=\"elementor-element elementor-element-03b2035 elementor-widget elementor-widget-text-editor\" data-id=\"03b2035\" data-element_type=\"widget\" data-widget_type=\"text-editor.default\">\n\t\t\t\t<div class=\"elementor-widget-container\">\n\t\t\t\t\t\t\t<p><span style=\"font-weight: 400;\">Coledocolit\u00edase \u00e9 a presen\u00e7a de c\u00e1lculos nos ductos biliares. Podem ocorrer por forma\u00e7\u00e3o de c\u00e1lculos na ves\u00edcula biliar que pode se deslocar at\u00e9 os ductos ou podem se formar nos pr\u00f3prios ductos. Esses c\u00e1lculos podem obstruir o fluxo normal da bile at\u00e9 o intestino. C\u00e1lculos de ducto biliar podem migrar para o duodeno de forma assintom\u00e1tica. Pode haver c\u00f3licas biliares quando os c\u00e1lculos causarem obstru\u00e7\u00f5es parciais. Obstru\u00e7\u00f5es completas provocam dilata\u00e7\u00e3o de vias biliares, icter\u00edcia e, algumas vezes, infec\u00e7\u00e3o bacteriana (=colangite). O ducto pancre\u00e1tico se une ao ducto biliar pr\u00f3ximo ao duodeno, onde eles desembocam num orif\u00edcio comum. Se o c\u00e1lculo bloquear a sa\u00edda do ducto pancre\u00e1tico, as enzimas pancre\u00e1ticas ficam &#8220;aprisionadas&#8221; no p\u00e2ncreas, causando inflam\u00e7\u00e3o do pancreas, a pancreatite aguda.\u00a0<\/span><\/p><p><span style=\"font-weight: 400;\">Se qualquer destes ductos persistir bloqueado por um per\u00edodo significante de tempo, pode ocorrer a infec\u00e7\u00e3o das estruturas do sistema biliar &#8211; o que pode ser grave e at\u00e9 mesmo fatal. Sinais de alarme de problemas s\u00e9rios s\u00e3o febre, icter\u00edcia (amarel\u00e3o) e dor persistente. Deve-se suspeitar de c\u00e1lculos comuns no duto biliar em pacientes com icter\u00edcia e c\u00f3lica biliar. Devem-se realizar bioqu\u00edmica hep\u00e1tica e exames de imagem. Na suspeita de obstru\u00e7\u00e3o biliar, colangiopancreatografia retr\u00f3grada endosc\u00f3pica (CPRE) e esfincterotomia s\u00e3o necess\u00e1rias para remover o c\u00e1lculo. Colangite aguda \u00e9 uma emerg\u00eancia que exige cuidados de suporte <\/span><span style=\"font-weight: 400;\">agressivos e urgente remo\u00e7\u00e3o endosc\u00f3pica ou cir\u00fargica dos c\u00e1lculos. A coledocolit\u00edase deve sempre ser tratada, mesmo se assintom\u00e1tica, devido ao risco de complica\u00e7\u00f5es graves, como a colangite e a pancreatite aguda. Como alternativa, esses pacientes tamb\u00e9m podem prosseguir diretamente para a colecistectomia laparosc\u00f3pica com colangiografia intra-operat\u00f3ria. <br \/><br \/>Os c\u00e1lculos identificados na colangiografia intra operat\u00f3ria podem ser removidos por explora\u00e7\u00e3o laparosc\u00f3pica. Mais raramente, os c\u00e1lculos podem ser localizados na via biliar intra hep\u00e1tica , ou seja, na parte das vias biliares que se localizam dentro do f\u00edgado. Em alguns casos pode ser necess\u00e1rio a remo\u00e7\u00e3o de parte do f\u00edgado para a resolu\u00e7\u00e3o do problema.<\/span><\/p>\t\t\t\t\t\t<\/div>\n\t\t\t\t<\/div>\n\t\t\t\t<div class=\"elementor-element elementor-element-a86b036 elementor-icon-list--layout-traditional elementor-list-item-link-full_width elementor-widget elementor-widget-icon-list\" data-id=\"a86b036\" data-element_type=\"widget\" data-widget_type=\"icon-list.default\">\n\t\t\t\t<div class=\"elementor-widget-container\">\n\t\t\t\t\t<ul class=\"elementor-icon-list-items\">\n\t\t\t\t\t\t\t<li class=\"elementor-icon-list-item\">\n\t\t\t\t\t\t\t\t\t\t\t<a href=\"https:\/\/www.cirurgiahpb.com.br\/#vias\">\n\n\t\t\t\t\t\t\t\t\t\t\t\t<span class=\"elementor-icon-list-icon\">\n\t\t\t\t\t\t\t<i aria-hidden=\"true\" class=\"fas fa-arrow-left\"><\/i>\t\t\t\t\t\t<\/span>\n\t\t\t\t\t\t\t\t\t\t<span class=\"elementor-icon-list-text\">Voltar para a p\u00e1gina inicial<\/span>\n\t\t\t\t\t\t\t\t\t\t\t<\/a>\n\t\t\t\t\t\t\t\t\t<\/li>\n\t\t\t\t\t\t<\/ul>\n\t\t\t\t<\/div>\n\t\t\t\t<\/div>\n\t\t\t\t<div class=\"elementor-element elementor-element-5d88078 elementor-widget elementor-widget-spacer\" data-id=\"5d88078\" data-element_type=\"widget\" data-widget_type=\"spacer.default\">\n\t\t\t\t<div class=\"elementor-widget-container\">\n\t\t\t\t\t<div class=\"elementor-spacer\">\n\t\t\t<div class=\"elementor-spacer-inner\"><\/div>\n\t\t<\/div>\n\t\t\t\t<\/div>\n\t\t\t\t<\/div>\n\t\t\t\t<div class=\"elementor-element elementor-element-9aa0dfe elementor-widget elementor-widget-menu-anchor\" data-id=\"9aa0dfe\" data-element_type=\"widget\" data-widget_type=\"menu-anchor.default\">\n\t\t\t\t<div class=\"elementor-widget-container\">\n\t\t\t\t\t<div id=\"vesiculabiliar\" class=\"elementor-menu-anchor\"><\/div>\n\t\t\t\t<\/div>\n\t\t\t\t<\/div>\n\t\t\t\t<div class=\"elementor-element elementor-element-ec6fa3f elementor-widget elementor-widget-heading\" data-id=\"ec6fa3f\" data-element_type=\"widget\" data-widget_type=\"heading.default\">\n\t\t\t\t<div class=\"elementor-widget-container\">\n\t\t\t<h2 class=\"elementor-heading-title elementor-size-default\">NEOPLASIAS MALIGNAS<\/h2>\t\t<\/div>\n\t\t\t\t<\/div>\n\t\t\t\t<div class=\"elementor-element elementor-element-3f813a7 elementor-widget elementor-widget-heading\" data-id=\"3f813a7\" data-element_type=\"widget\" data-widget_type=\"heading.default\">\n\t\t\t\t<div class=\"elementor-widget-container\">\n\t\t\t<h3 class=\"elementor-heading-title elementor-size-default\">C\u00e2ncer de Ves\u00edcula Biliar<\/h3>\t\t<\/div>\n\t\t\t\t<\/div>\n\t\t\t\t<div class=\"elementor-element elementor-element-9e3d40c elementor-widget elementor-widget-text-editor\" data-id=\"9e3d40c\" data-element_type=\"widget\" data-widget_type=\"text-editor.default\">\n\t\t\t\t<div class=\"elementor-widget-container\">\n\t\t\t\t\t\t\t<p><span style=\"font-weight: 400;\">O c\u00e2ncer de ves\u00edcula biliar representa 3% de todas as neoplasias malignas do trato digestivo. Ele pode ser diagnosticado durante os exames que investigam algum sintoma do paciente ou durante a an\u00e1lise no laborat\u00f3rio de uma ves\u00edcula que foi retirada por outras causas que n\u00e3o se sabia ter o c\u00e2ncer. O tratamento depende do momento em que foi descoberto. <\/span><\/p>\t\t\t\t\t\t<\/div>\n\t\t\t\t<\/div>\n\t\t\t\t<div class=\"elementor-element elementor-element-ce99e74 elementor-widget elementor-widget-heading\" data-id=\"ce99e74\" data-element_type=\"widget\" data-widget_type=\"heading.default\">\n\t\t\t\t<div class=\"elementor-widget-container\">\n\t\t\t<h4 class=\"elementor-heading-title elementor-size-default\">Diagn\u00f3stico<\/h4>\t\t<\/div>\n\t\t\t\t<\/div>\n\t\t\t\t<div class=\"elementor-element elementor-element-6cc53c3 elementor-widget elementor-widget-text-editor\" data-id=\"6cc53c3\" data-element_type=\"widget\" data-widget_type=\"text-editor.default\">\n\t\t\t\t<div class=\"elementor-widget-container\">\n\t\t\t\t\t\t\t<p><span style=\"font-weight: 400;\">A neoplasia de ves\u00edcula biliar \u00e9 frequentemente diagnosticada em est\u00e1dios avan\u00e7ados devido \u00e0 natureza agressiva do tumor, que metastatiza rapidamente. Outro fator que contribui para o diagn\u00f3stico tardio \u00e9 a apresenta\u00e7\u00e3o cl\u00ednica que simula uma c\u00f3lica biliar ou uma colecistite cr\u00f4nica (inflama\u00e7\u00e3o cr\u00f4nica). No entanto, a forma mais comum de diagn\u00f3stico \u00e9 o achado incidental depois de uma colecistectomia por presumida doen\u00e7a benigna da ves\u00edcula biliar. Outras formas de diagn\u00f3stico s\u00e3o definidas por meio de massas suspeitas detectadas por exames de imagem ou obstru\u00e7\u00e3o de via biliar com icter\u00edcia e dor no hipoc\u00f4ndrio direito, estando estes \u00faltimos associados com pior progn\u00f3stico e menor taxa de ressec\u00e7\u00e3o cir\u00fargica. <\/span><\/p>\t\t\t\t\t\t<\/div>\n\t\t\t\t<\/div>\n\t\t\t\t<div class=\"elementor-element elementor-element-d0accb2 elementor-widget elementor-widget-heading\" data-id=\"d0accb2\" data-element_type=\"widget\" data-widget_type=\"heading.default\">\n\t\t\t\t<div class=\"elementor-widget-container\">\n\t\t\t<h4 class=\"elementor-heading-title elementor-size-default\">C\u00e2ncer de ves\u00edcula biliar incidental<\/h4>\t\t<\/div>\n\t\t\t\t<\/div>\n\t\t\t\t<div class=\"elementor-element elementor-element-8a7cb82 elementor-widget elementor-widget-text-editor\" data-id=\"8a7cb82\" data-element_type=\"widget\" data-widget_type=\"text-editor.default\">\n\t\t\t\t<div class=\"elementor-widget-container\">\n\t\t\t\t\t\t\t<p><span style=\"font-weight: 400;\">Ocorrem entre 0,2% e 3% dos pacientes submetidos \u00e0 colecistectomia. Na avalia\u00e7\u00e3o do paciente com diagn\u00f3stico de neoplasia de ves\u00edcula em exame anatomopatol\u00f3gico a decis\u00e3o de se acrescentar mais uma cirurgia para amplia\u00e7\u00e3o das margens depende da profundidade do tumor. Para tumores mais superficiais, chamados pela classifica\u00e7\u00e3o TNM de Tis e T1a, <\/span><span style=\"font-weight: 400;\">nenhuma ressec\u00e7\u00e3o adicional \u00e9 necess\u00e1ria. Para tumores T1b e em est\u00e1gio superior, a ressec\u00e7\u00e3o hep\u00e1tica adicional \u00e9 indicada, pois focos de tumor podem ser encontrados em at\u00e9 2 cm de dist\u00e2ncia da margem do tumor prim\u00e1rio.\u00a0<\/span><\/p><p><span style=\"font-weight: 400;\">Tomografia (TC) de t\u00f3rax e de abd\u00f4men ou resson\u00e2ncia magn\u00e9tica abdominal (RNM) devem ser realizadas para excluir doen\u00e7a disseminada. A recupera\u00e7\u00e3o deve ser realizada o mais cedo poss\u00edvel, por\u00e9m, pode levar de 2 a 4 semanas ap\u00f3s a colecistectomia inicial, pois demanda-se um tempo para que a an\u00e1lise da ves\u00edcula final esteja dispon\u00edvel, todos os exames de estadiamento sejam realizados, e que o paciente esteja apto para recupera\u00e7\u00e3o.\u00a0<\/span><\/p>\t\t\t\t\t\t<\/div>\n\t\t\t\t<\/div>\n\t\t\t\t<div class=\"elementor-element elementor-element-d4aea54 elementor-widget elementor-widget-heading\" data-id=\"d4aea54\" data-element_type=\"widget\" data-widget_type=\"heading.default\">\n\t\t\t\t<div class=\"elementor-widget-container\">\n\t\t\t<h4 class=\"elementor-heading-title elementor-size-default\">C\u00e2ncer de ves\u00edcula biliar previamente diagnosticado<\/h4>\t\t<\/div>\n\t\t\t\t<\/div>\n\t\t\t\t<div class=\"elementor-element elementor-element-dbd7044 elementor-widget elementor-widget-text-editor\" data-id=\"dbd7044\" data-element_type=\"widget\" data-widget_type=\"text-editor.default\">\n\t\t\t\t<div class=\"elementor-widget-container\">\n\t\t\t\t\t\t\t<p><span style=\"font-weight: 400;\">O planejamento do tratamento cir\u00fargico no c\u00e2ncer de ves\u00edcula baseia-se no estadiamento. Os exames necess\u00e1rios s\u00e3o tomografia computadorizada (TC) de t\u00f3rax, abdome e pelve; resson\u00e2ncia magn\u00e9tica de abdome superior com colangioresson\u00e2ncia.\u00a0<\/span><\/p><p><span style=\"font-weight: 400;\">A cirurgia deve ser planejada caso a caso, pesando as condi\u00e7\u00f5es funcionais,<\/span> <span style=\"font-weight: 400;\">doen\u00e7as associadas, extens\u00e3o da doen\u00e7a e riscos para o paciente, permitindo um<\/span> <span style=\"font-weight: 400;\">tratamento personalizado.<br \/><br \/>Nos tumores da ves\u00edcula biliar, a cirurgia mais comum \u00e9 a<\/span> <span style=\"font-weight: 400;\">retirada da ves\u00edcula junto com a retirada de parte do f\u00edgado, onde a ves\u00edcula est\u00e1<\/span> <span style=\"font-weight: 400;\">aderida, e a linfadenectomia da regi\u00e3o dos vasos hep\u00e1ticos. Em rela\u00e7\u00e3o a extens\u00e3o<\/span><span style=\"font-weight: 400;\"> da hepatectomia, esta pode variar desde 2 cm de profundidade no leito da ves\u00edcula nos segmentos IVb e V, e de forma mais regrada, a ressec\u00e7\u00e3o anat\u00f4mica dos segmentos do f\u00edgado IVb e V. Em rela\u00e7\u00e3o a via biliar, faz-se necess\u00e1rio a obten\u00e7\u00e3o de margens livres, seja a do c\u00edstico para casos iniciais, seja a da via biliar principal em casos mais avan\u00e7ados, levando a necessidade de anastomoses bilio-digestivas.\u00a0<\/span><\/p><p><span style=\"font-weight: 400;\">Quimioterapia p\u00f3s-operat\u00f3ria ou radioquimioterapia parecem estar associadas a um benef\u00edcio na sobrevida em pacientes com tumores da \u00e1rvore biliar com doen\u00e7a em g\u00e2nglios ou margens microscopicamente positivas. A melhor estrat\u00e9gia ainda n\u00e3o est\u00e1 definida, mas inclui regimes com base em fluoropirimidinas, com base em gencitabina ou combina\u00e7\u00f5es com radioquimioterapia.<\/span><\/p>\t\t\t\t\t\t<\/div>\n\t\t\t\t<\/div>\n\t\t\t\t<div class=\"elementor-element elementor-element-9bff90f elementor-widget elementor-widget-heading\" data-id=\"9bff90f\" data-element_type=\"widget\" data-widget_type=\"heading.default\">\n\t\t\t\t<div class=\"elementor-widget-container\">\n\t\t\t<h4 class=\"elementor-heading-title elementor-size-default\">C\u00e2ncer de ves\u00edcula irressec\u00e1vel<\/h4>\t\t<\/div>\n\t\t\t\t<\/div>\n\t\t\t\t<div class=\"elementor-element elementor-element-03547e1 elementor-widget elementor-widget-text-editor\" data-id=\"03547e1\" data-element_type=\"widget\" data-widget_type=\"text-editor.default\">\n\t\t\t\t<div class=\"elementor-widget-container\">\n\t\t\t\t\t\t\t<p><span style=\"font-weight: 400;\">A quimioterapia \u00e9 a terapia tradicional para c\u00e2ncer de ves\u00edcula irressec\u00e1vel (n\u00edvel 1 de evid\u00eancia para uso de gemcitabina \/ cisplatina nas diretrizes). O estudo ingl\u00eas ABC-02 sustenta o uso da combina\u00e7\u00e3o gemcitabina + cisplatina em casos de tumores avan\u00e7ados do trato biliar ou metast\u00e1tico. N\u00e3o h\u00e1 terapia sist\u00eamica de segunda linha estabelecida, embora terapias baseadas em fluoropirimidina (em monoterapia ou em combina\u00e7\u00e3o com outros citot\u00f3xicos) sejam as vezes utilizadas. A radioquimioterapia tem sido considerada uma op\u00e7\u00e3o poss\u00edvel de acordo com estudos n\u00e3o randomizados com taxas de sobrevida medianas entre 9 e 14 meses.<\/span><\/p>\t\t\t\t\t\t<\/div>\n\t\t\t\t<\/div>\n\t\t\t\t<div class=\"elementor-element elementor-element-ad575e0 elementor-widget elementor-widget-heading\" data-id=\"ad575e0\" data-element_type=\"widget\" data-widget_type=\"heading.default\">\n\t\t\t\t<div class=\"elementor-widget-container\">\n\t\t\t<h4 class=\"elementor-heading-title elementor-size-default\">Terapia Paliativa <\/h4>\t\t<\/div>\n\t\t\t\t<\/div>\n\t\t\t\t<div class=\"elementor-element elementor-element-838cd4a elementor-widget elementor-widget-text-editor\" data-id=\"838cd4a\" data-element_type=\"widget\" data-widget_type=\"text-editor.default\">\n\t\t\t\t<div class=\"elementor-widget-container\">\n\t\t\t\t\t\t\t<p><span style=\"font-weight: 400;\">Semelhante a outros c\u00e2nceres biliares, a base do tratamento paliativo no c\u00e2ncer do trato biliar \u00e9 a manuten\u00e7\u00e3o de drenagem biliar adequada, nutri\u00e7\u00e3o e al\u00edvio de sintomas compressivos locais. A drenagem biliar pode ser obtida por meio da coloca\u00e7\u00e3o de cateter percut\u00e2neo ou stents biliares endosc\u00f3picos e \u00e9 idealmente realizado antes do in\u00edcio da quimioterapia. Tumores biliares podem causar compress\u00e3o duodenal ou g\u00e1strica, necessitando de acesso para alimenta\u00e7\u00e3o ou desvio gastrojejunal para manter uma nutri\u00e7\u00e3o adequada <\/span><\/p>\t\t\t\t\t\t<\/div>\n\t\t\t\t<\/div>\n\t\t\t\t<div class=\"elementor-element elementor-element-f180132 elementor-icon-list--layout-traditional elementor-list-item-link-full_width elementor-widget elementor-widget-icon-list\" data-id=\"f180132\" data-element_type=\"widget\" data-widget_type=\"icon-list.default\">\n\t\t\t\t<div class=\"elementor-widget-container\">\n\t\t\t\t\t<ul class=\"elementor-icon-list-items\">\n\t\t\t\t\t\t\t<li class=\"elementor-icon-list-item\">\n\t\t\t\t\t\t\t\t\t\t\t<a href=\"https:\/\/www.cirurgiahpb.com.br\/#vias\">\n\n\t\t\t\t\t\t\t\t\t\t\t\t<span class=\"elementor-icon-list-icon\">\n\t\t\t\t\t\t\t<i aria-hidden=\"true\" class=\"fas fa-arrow-left\"><\/i>\t\t\t\t\t\t<\/span>\n\t\t\t\t\t\t\t\t\t\t<span class=\"elementor-icon-list-text\">Voltar para a p\u00e1gina inicial<\/span>\n\t\t\t\t\t\t\t\t\t\t\t<\/a>\n\t\t\t\t\t\t\t\t\t<\/li>\n\t\t\t\t\t\t<\/ul>\n\t\t\t\t<\/div>\n\t\t\t\t<\/div>\n\t\t\t\t<div class=\"elementor-element elementor-element-d7b130b elementor-widget elementor-widget-menu-anchor\" data-id=\"d7b130b\" data-element_type=\"widget\" data-widget_type=\"menu-anchor.default\">\n\t\t\t\t<div class=\"elementor-widget-container\">\n\t\t\t\t\t<div id=\"viasbiliares\" class=\"elementor-menu-anchor\"><\/div>\n\t\t\t\t<\/div>\n\t\t\t\t<\/div>\n\t\t\t\t<div class=\"elementor-element elementor-element-115ce62 elementor-widget elementor-widget-spacer\" data-id=\"115ce62\" data-element_type=\"widget\" data-widget_type=\"spacer.default\">\n\t\t\t\t<div class=\"elementor-widget-container\">\n\t\t\t\t\t<div class=\"elementor-spacer\">\n\t\t\t<div class=\"elementor-spacer-inner\"><\/div>\n\t\t<\/div>\n\t\t\t\t<\/div>\n\t\t\t\t<\/div>\n\t\t\t\t<div class=\"elementor-element elementor-element-c22772c elementor-widget elementor-widget-heading\" data-id=\"c22772c\" data-element_type=\"widget\" data-widget_type=\"heading.default\">\n\t\t\t\t<div class=\"elementor-widget-container\">\n\t\t\t<h3 class=\"elementor-heading-title elementor-size-default\">C\u00e2ncer Vias Biliares<\/h3>\t\t<\/div>\n\t\t\t\t<\/div>\n\t\t\t\t<div class=\"elementor-element elementor-element-b6148f0 elementor-widget elementor-widget-text-editor\" data-id=\"b6148f0\" data-element_type=\"widget\" data-widget_type=\"text-editor.default\">\n\t\t\t\t<div class=\"elementor-widget-container\">\n\t\t\t\t\t\t\t<p>Lorem ipsum dolor sit amet, consectetur adipiscing elit. Ut elit tellus, luctus nec ullamcorper mattis, pulvinar dapibus leo.<\/p>\t\t\t\t\t\t<\/div>\n\t\t\t\t<\/div>\n\t\t\t\t<div class=\"elementor-element elementor-element-a06acc7 elementor-icon-list--layout-traditional elementor-list-item-link-full_width elementor-widget elementor-widget-icon-list\" data-id=\"a06acc7\" data-element_type=\"widget\" data-widget_type=\"icon-list.default\">\n\t\t\t\t<div class=\"elementor-widget-container\">\n\t\t\t\t\t<ul class=\"elementor-icon-list-items\">\n\t\t\t\t\t\t\t<li class=\"elementor-icon-list-item\">\n\t\t\t\t\t\t\t\t\t\t\t<a href=\"https:\/\/www.cirurgiahpb.com.br\/#vias\">\n\n\t\t\t\t\t\t\t\t\t\t\t\t<span class=\"elementor-icon-list-icon\">\n\t\t\t\t\t\t\t<i aria-hidden=\"true\" class=\"fas fa-arrow-left\"><\/i>\t\t\t\t\t\t<\/span>\n\t\t\t\t\t\t\t\t\t\t<span class=\"elementor-icon-list-text\">Voltar para a p\u00e1gina inicial<\/span>\n\t\t\t\t\t\t\t\t\t\t\t<\/a>\n\t\t\t\t\t\t\t\t\t<\/li>\n\t\t\t\t\t\t<\/ul>\n\t\t\t\t<\/div>\n\t\t\t\t<\/div>\n\t\t\t\t<div class=\"elementor-element elementor-element-a78c8aa elementor-widget elementor-widget-spacer\" data-id=\"a78c8aa\" data-element_type=\"widget\" data-widget_type=\"spacer.default\">\n\t\t\t\t<div class=\"elementor-widget-container\">\n\t\t\t\t\t<div class=\"elementor-spacer\">\n\t\t\t<div class=\"elementor-spacer-inner\"><\/div>\n\t\t<\/div>\n\t\t\t\t<\/div>\n\t\t\t\t<\/div>\n\t\t\t\t<div class=\"elementor-element elementor-element-f8b7b09 elementor-widget elementor-widget-heading\" data-id=\"f8b7b09\" data-element_type=\"widget\" data-widget_type=\"heading.default\">\n\t\t\t\t<div class=\"elementor-widget-container\">\n\t\t\t<h2 class=\"elementor-heading-title elementor-size-default\">Refer\u00eancias<\/h2>\t\t<\/div>\n\t\t\t\t<\/div>\n\t\t\t\t<div class=\"elementor-element elementor-element-267ee5f elementor-widget elementor-widget-text-editor\" data-id=\"267ee5f\" data-element_type=\"widget\" data-widget_type=\"text-editor.default\">\n\t\t\t\t<div class=\"elementor-widget-container\">\n\t\t\t\t\t\t\t<p><span style=\"font-weight: 400;\">&#8211; Diretrizes Oncol\u00f3gicas: C\u00e2ncer de Ves\u00edcula Biliar. Laporte GA, Oliveira AF,<\/span> <span style=\"font-weight: 400;\">Lucchese AM, Kalil AN, Souza e Silva JT, Santos MTM. In:<\/span> <span style=\"font-weight: 400;\">https:\/\/diretrizesoncologicas.com.br\/wp-content\/uploads\/2018\/10\/Diretrizes-on<\/span> <span style=\"font-weight: 400;\">col%C3%B3gicas-2_Parte14.pdf<\/span><span style=\"font-weight: 400;\">\u00a0<\/span><\/p><p><span style=\"font-weight: 400;\">&#8211; Surgical resection for non-Asian intrahepatic lithiasis: The Brazilian<\/span> <span style=\"font-weight: 400;\">experience. Torres OJM, Coelho FF, Kalil AN, Belotto M, Ramos EJ,<\/span> <span style=\"font-weight: 400;\">Lucchese AM, Moraes-Junior JM, Amaral PCG, Fonseca GM, Herman P.<\/span> <span style=\"font-weight: 400;\">Asian Journal of Surgery 44 (2021) 553e559<\/span><span style=\"font-weight: 400;\">\u00a0<\/span><\/p><p><span style=\"font-weight: 400;\">&#8211; Sabiston \u2013 Textbook of Surgery. 21Ed. Elsevier<\/span><\/p>\t\t\t\t\t\t<\/div>\n\t\t\t\t<\/div>\n\t\t\t\t\t<\/div>\n\t\t<\/div>\n\t\t\t\t<div class=\"elementor-column elementor-col-33 elementor-top-column elementor-element elementor-element-057fde5\" data-id=\"057fde5\" data-element_type=\"column\">\n\t\t\t<div class=\"elementor-widget-wrap\">\n\t\t\t\t\t\t\t<\/div>\n\t\t<\/div>\n\t\t\t\t\t<\/div>\n\t\t<\/section>\n\t\t\t\t<\/div>\n\t\t","protected":false},"excerpt":{"rendered":"<p>\u00cdndice VES\u00cdCULA BILIAR E VIAS BILIARES A ves\u00edcula biliar (com sete a dez cent\u00edmetros de comprimento), situa-se na por\u00e7\u00e3o \u00ednfero-anterior do f\u00edgado na jun\u00e7\u00e3o de seus lobos direito e esquerdo. A fun\u00e7\u00e3o da ves\u00edcula biliar \u00e9 o armazenamento de bile.\u00a0 As vias biliares s\u00e3o o conjunto de ductos encarregados de transportar a bile de dentro [&hellip;]<\/p>\n","protected":false},"author":1,"featured_media":0,"parent":0,"menu_order":0,"comment_status":"closed","ping_status":"closed","template":"elementor_header_footer","meta":{"_exactmetrics_skip_tracking":false,"_exactmetrics_sitenote_active":false,"_exactmetrics_sitenote_note":"","_exactmetrics_sitenote_category":0,"footnotes":""},"yoast_head":"<!-- This site is optimized with the Yoast SEO plugin v22.3 - https:\/\/yoast.com\/wordpress\/plugins\/seo\/ -->\n<title>Patologias da Ves\u00edcula \/ Vias Biliares - Cirurgia HPB<\/title>\n<meta name=\"robots\" content=\"index, follow, max-snippet:-1, max-image-preview:large, max-video-preview:-1\" \/>\n<link rel=\"canonical\" href=\"https:\/\/www.cirurgiahpb.com.br\/patologias-da-vesicula-vias-biliares\/\" \/>\n<meta property=\"og:locale\" content=\"pt_BR\" \/>\n<meta property=\"og:type\" content=\"article\" \/>\n<meta property=\"og:title\" content=\"Patologias da Ves\u00edcula \/ Vias Biliares - Cirurgia HPB\" \/>\n<meta property=\"og:description\" content=\"\u00cdndice VES\u00cdCULA BILIAR E VIAS BILIARES A ves\u00edcula biliar (com sete a dez cent\u00edmetros de comprimento), situa-se na por\u00e7\u00e3o \u00ednfero-anterior do f\u00edgado na jun\u00e7\u00e3o de seus lobos direito e esquerdo. A fun\u00e7\u00e3o da ves\u00edcula biliar \u00e9 o armazenamento de bile.\u00a0 As vias biliares s\u00e3o o conjunto de ductos encarregados de transportar a bile de dentro [&hellip;]\" \/>\n<meta property=\"og:url\" content=\"https:\/\/www.cirurgiahpb.com.br\/patologias-da-vesicula-vias-biliares\/\" \/>\n<meta property=\"og:site_name\" content=\"Cirurgia HPB\" \/>\n<meta property=\"article:modified_time\" content=\"2023-02-17T13:05:29+00:00\" \/>\n<meta name=\"twitter:card\" content=\"summary_large_image\" \/>\n<meta name=\"twitter:label1\" content=\"Est. tempo de leitura\" \/>\n\t<meta name=\"twitter:data1\" content=\"10 minutos\" \/>\n<script type=\"application\/ld+json\" class=\"yoast-schema-graph\">{\"@context\":\"https:\/\/schema.org\",\"@graph\":[{\"@type\":\"WebPage\",\"@id\":\"https:\/\/www.cirurgiahpb.com.br\/patologias-da-vesicula-vias-biliares\/\",\"url\":\"https:\/\/www.cirurgiahpb.com.br\/patologias-da-vesicula-vias-biliares\/\",\"name\":\"Patologias da Ves\u00edcula \/ Vias Biliares - Cirurgia HPB\",\"isPartOf\":{\"@id\":\"https:\/\/www.cirurgiahpb.com.br\/#website\"},\"datePublished\":\"2021-12-03T07:44:47+00:00\",\"dateModified\":\"2023-02-17T13:05:29+00:00\",\"breadcrumb\":{\"@id\":\"https:\/\/www.cirurgiahpb.com.br\/patologias-da-vesicula-vias-biliares\/#breadcrumb\"},\"inLanguage\":\"pt-BR\",\"potentialAction\":[{\"@type\":\"ReadAction\",\"target\":[\"https:\/\/www.cirurgiahpb.com.br\/patologias-da-vesicula-vias-biliares\/\"]}]},{\"@type\":\"BreadcrumbList\",\"@id\":\"https:\/\/www.cirurgiahpb.com.br\/patologias-da-vesicula-vias-biliares\/#breadcrumb\",\"itemListElement\":[{\"@type\":\"ListItem\",\"position\":1,\"name\":\"In\u00edcio\",\"item\":\"https:\/\/www.cirurgiahpb.com.br\/\"},{\"@type\":\"ListItem\",\"position\":2,\"name\":\"Patologias da Ves\u00edcula \/ Vias Biliares\"}]},{\"@type\":\"WebSite\",\"@id\":\"https:\/\/www.cirurgiahpb.com.br\/#website\",\"url\":\"https:\/\/www.cirurgiahpb.com.br\/\",\"name\":\"Cirurgia HPB\",\"description\":\"\",\"potentialAction\":[{\"@type\":\"SearchAction\",\"target\":{\"@type\":\"EntryPoint\",\"urlTemplate\":\"https:\/\/www.cirurgiahpb.com.br\/?s={search_term_string}\"},\"query-input\":\"required name=search_term_string\"}],\"inLanguage\":\"pt-BR\"}]}<\/script>\n<!-- \/ Yoast SEO plugin. -->","yoast_head_json":{"title":"Patologias da Ves\u00edcula \/ Vias Biliares - Cirurgia HPB","robots":{"index":"index","follow":"follow","max-snippet":"max-snippet:-1","max-image-preview":"max-image-preview:large","max-video-preview":"max-video-preview:-1"},"canonical":"https:\/\/www.cirurgiahpb.com.br\/patologias-da-vesicula-vias-biliares\/","og_locale":"pt_BR","og_type":"article","og_title":"Patologias da Ves\u00edcula \/ Vias Biliares - Cirurgia HPB","og_description":"\u00cdndice VES\u00cdCULA BILIAR E VIAS BILIARES A ves\u00edcula biliar (com sete a dez cent\u00edmetros de comprimento), situa-se na por\u00e7\u00e3o \u00ednfero-anterior do f\u00edgado na jun\u00e7\u00e3o de seus lobos direito e esquerdo. 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