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Endoskopie heute 2015; 28(01): 20-25
DOI: 10.1055/s-0034-1399205
Originalarbeit

Breitflächige Duodenal- und Papillenadenome – eine Herausforderung im Grenzbereich zwischen interventioneller Endoskopie und Chirurgie

Giant Lateral Spreading Duodenal and Papillary Adenoma – a Therapeutic Challenge between Interventional Endoscopy and Surgery
S. Seewald
1   GastroZentrum, Klinik Hirslanden Zürich
,
P. Bertschinger
1   GastroZentrum, Klinik Hirslanden Zürich
,
A. L. Jacob
2   Zentrum für Mikrotherapie, Klinik Hirslanden Zürich
,
J. Schmidt
3   Chirurgisches Zentrum Zürich, Klinik Hirslanden Zürich
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Zusammenfassung

Die Resektion von breitflächigen Duodenal- und Papillenadenomen gehört zu den endoskopischen Eingriffen mit einem deutlich erhöhten Komplikationsrisiko. Die Indikationsstellung für eine endoskopische Resektion bedarf deshalb einer spezifischen Risikoabschätzung. Chirurgische Verfahren wie die pankreaserhaltende Duodenektomie oder transduodenale Papillekomie sind dabei mögliche Alternativen. Der folgende Artikel gibt einen Überblick über die aktuellen endoskopischen und chirurgischen Verfahren. Des Weiteren werden wichtige praktische Aspekte des klinischen Managements, der Diagnostik und Therapie mit Beispielen diskutiert.

Abstract

Endoscopic resection of giant duodenal and papillary adenoma is associated with a significant higher complication rate. Therefore the indication of an endoscopic resection requires a specific preinterventional risk analysis. Surgical techniques such as pancreas-preserving duodenectomy and transduodenal local excisions of tumors of the papilla of Vater are potential alternatives. The following article describes the latest endoscopic and surgical techniques. Furthermore, important practical aspects of the endoscopic assessment, therapy and the clinical management are discussed.

Schlüsselwörter

großflächige Duodenaladenome - Papillenadenome - EMR - ESD - pankreaserhaltende Duodenektomie - transduodenale Papillektomie

Key words

giant lateral spreading duodenal adenoma - papillary adenoma - EMR - ESD - pancreas-preserving duodenectomy - transduodenal local excisions of tumors of the papilla of Vater


Publication History

Publication Date:
23 March 2015 (online)

© 2015. Thieme. All rights reserved.

Georg Thieme Verlag KG
Stuttgart · New York

 

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