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2026, Número 3

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Rev Mex Anest 2026; 49 (3)


Manejo anestésico en la hepatectomía de un paciente cirrótico con carcinoma hepatocelular: un reporte de caso

Fernandez-Delgado DM, Montesinos SY, Estela-Fernandez CA, Aguilar-Marín IC

Idioma: Ingles.
Referencias bibliográficas: 22
Paginas: 201-205
Archivo PDF: 1843.21 Kb.


RESUMEN

Introducción: la resección quirúrgica en el carcinoma hepatocelular (CHC) sigue siendo uno de los métodos curativos más eficaces; sin embargo, la complejidad del manejo perioperatorio es controversial referente a las guías actuales. Objetivo: describir los enfoques anestésicos y perioperatorios utilizados en un paciente con cirrosis sometido a hepatectomía radical por CHC, haciendo hincapié en los determinantes relevantes de los resultados quirúrgicos. Presentación del caso: hombre de 82 años diagnosticado con carcinoma hepatocelular en el lóbulo derecho por cirrosis alcohólica (Child-Pugh A). Se sometió a una hepatectomía radical derecha tras una embolización portal preoperatoria. Se utilizó anestesia total intravenosa con infusión controlada. Se mantuvo un control continuo de la presión venosa central mediante la restricción de líquidos combinada con la infusión de vasopresores. Los cuidados postoperatorios incluyeron medidas de protección hepática y manejo de complicaciones. Posteriormente, el paciente fue dado de alta con seguimiento ambulatorio. Conclusión: los riesgos quirúrgicos en este caso fueron considerables, pero el resultado fue positivo gracias a un manejo preoperatorio y perioperatorio adecuado. Es necesario investigar como estos factores influyen en el resultado quirúrgico de ciertas patologías de difícil manejo.


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