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Maligne Tumoren des Pankreas und der periampullären Region

  • Chapter
Praxis der Viszeralchirurgie

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Zusammenfassung

Das duktale Adenokarzinom des Pankreas hat bis heute die schlechteste Prognose aller gastrointestinalen Tumore. Auch wenn es gelingt die Tumore komplett zu resezieren, wird selten über ein 5-Jahresüberleben von mehr als 10% berichtet. Für eine R0-Resektion kommen jedoch nur ein Drittel der diagnostizierten Patienten in Frage. Vordringliches Ziel des präoperativen Stagings ist deshalb, RO-resezierbare Patienten sicher zu identifizieren, um unnötige Laparotomien zu vermeiden. Bis heute ist die R0-Resektion die einzige Möglichkeit, die Prognose der Patienten entscheidend zu verbessern. Periampulläre Tumore haben eine deutlich bessere Prognose als das Adenokarzinom. Nach R0-Resektion liegt die 5-Jahresüberlebensrate beim distalen Choledochuskarzinom und beim Papillenkarzinom bei 20% bzw. 40%. In den letzten Jahren ist die Chirurgie des Pankreas zunehmend standardisiert worden. Dadurch konnte die Letalität der partiellen Duodenopankreatektomie in Zentren unter 5% gesenkt werden. Dies bedeutet aber auch, dass es in der Pankreaschirurgie zunehmend zu einer Spezialisierung kommt Adjuvante oder neoadjuvante Therapieverfahren haben bisher noch keinen Stellenwert. Auf absehbare Zeit wird die Operation der Eckpfeiler der Therapie bleiben.

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  1. J. D. Roder
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  2. A. Sendler
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  3. U. Fink
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  4. F. Zimmermann
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Editors and Affiliations

  1. Chirurgische Klinik und Poliklinik, Technische Universität München, Ismaninger Straße 22, 81675, München, Deutschland

    J. R. Siewert

  2. Department für Chirurgie, Kantonsspital Basel, Spitalstraße 21, 4031, Basel, Schweiz

    F. Harder

  3. Klinik für Allgemeinchirurgie, Zentrum für Operative Medizin I, Baldingerstraße, 35043, Marburg, Deutschland

    M. Rothmund

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Roder, J.D., Sendler, A., Fink, U., Zimmermann, F. (2001). Maligne Tumoren des Pankreas und der periampullären Region. In: Siewert, J.R., Harder, F., Rothmund, M. (eds) Praxis der Viszeralchirurgie. Springer, Berlin, Heidelberg. https://doi.org/10.1007/978-3-662-09420-4_30

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