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Organsparende Exstirpation oder große onkologische Operation bei zystischen Pankreasneoplasien?

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Erkrankungen des Pankreas

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Zusammenfassung

Zystische Neoplasien des Pankreas, die persistierende Symptome verursachen, stellen eine Indikation zur operativen Therapie dar. Zystische Tumoren, die über 4 cm groß sind, rasches Tumorwachstum zeigen, eine Pankreashauptgang-Dilatation über 5–9 mm verursachen, Tumorknoten und Wandverdickungen aufweisen sowie Zeichen eines malignen Tumors präsentieren, sind operationspflichtig. Bei asymptomatischen zystischen Tumoren, die zufällig gefunden werden, wird ein Wechsel vom Überwachungsprotokoll zur operativen Therapie empfohlen, bei IPMN-Hauptgangtumoren und allen MCN- und SPsN-Läsionen, wenn die Patienten für einen chirurgischen Eingriff fit sind. Die Vorteile einer limitierten Tumorexstirpation im Vergleich zur onkologischen Multiorganresektion sind durch prospektive kontrollierte und Fallkontrollstudien für die Mittelsegmentresektion und die duodenumerhaltende totale Pankreaskopfresektion belegt.

Mit Unterstützung der Stiftung Pankreaskarzinom, Ulm.

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Authors and Affiliations

  1. c/o Universitätsklinikum Ulm,, Universität Ulm, Albert-Einstein-Allee 23, 89081Ulm, Deutschland

    Hans G. Beger

  2. Abteilung für Allgemeine, Thorax-, Gefäß- und Transplantationschirurgie, Universitätsmedizin Rostock, Schillingallee 35, 18057, Rostock, Deutschland

    Bettina M. Rau

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Correspondence to Hans G. Beger .

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Editors and Affiliations

  1. Abt. Allgemeine- und Visceralchirurgie, Universitätsklinikum Ulm, Germany

    Hans G. Beger

  2. Klinik für Allgemein-, Viszeral- und Transplantationschirurgie, Universitätsklinikum Heidelberg, Germany

    Markus W. Büchler

  3. Allgemein-, Viszeral- und Gefäßchirurgie, Universitätsklinikum Halle, Sachsen-Anhalt, Germany

    Henning Dralle

  4. Klinik und Poliklinik für Innere Medizin, Universitätsmedizin Greifswald, Germany

    Markus M. Lerch

  5. und Hepatologie (KGHI), Universitätsklinikum Magdeburg, Germany

    Peter Malfertheiner

  6. FB Gastroenterologie und Hepatologie, Universitätsklinikum Leipzig, Sachsen, Germany

    Joachim Mössner

  7. ehemals Klinikum der Stadt Ludwigshafen gGmbH, Rheinland-Pfalz, Germany

    Jürgen F. Riemann

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Beger, H., Rau, B. (2013). Organsparende Exstirpation oder große onkologische Operation bei zystischen Pankreasneoplasien?. In: Beger, H., et al. Erkrankungen des Pankreas. Springer, Berlin, Heidelberg. https://doi.org/10.1007/978-3-642-37964-2_54

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