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Onkologie up2date 2022; 4(04): 325-341
DOI: 10.1055/a-1911-4200
Tumoren des Gastrointestinaltraktes

Duodenaladenome und -karzinome: chirurgische Therapiekonzepte

Michael Ghadimi
,
Jochen Gaedcke
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Tumoren des Duodenums sind selten und meist Zufallsbefunde der Gastroskopie. Neben den rein benignen Läsionen stellen Veränderungen epithelialen Ursprungs eine relevante Gruppe aufgrund ihres Entartungspotenzials mit dann schlechter Prognose für den Patienten dar. In der Folge sollen diese mit besonderem Schwerpunkt auf den Therapieoptionen beschrieben werden.
Kernaussagen

  • Tumoren des Duodenums sind selten.

  • Zu den häufigsten Tumoren des Duodenums zählen GIST, NET oder Adenome.

  • Die Abklärung des Duodenums bei Patienten mit „Polyposis-Erkrankungen“ ist obligat.

  • Die Abtragung von duodenalen Tumoren sollte primär endoskopisch erfolgen.

  • Die Lokalisation der Adenome wird in papillär und nicht papillär unterschieden.

  • Malignitätsverdacht, inkomplette Abtragung oder technische Gründe sprechen für eine chirurgische Therapie.

  • Bei gutartigen Befunden orientiert sich das chirurgische Verfahren an der Lage des Prozesses.

  • Bei Malignomverdacht ist die Pankreaskopfresektion indiziert.

  • Eine regelmäßige Nachsorge ist nach Resektion gutartiger Befunde indiziert.

Schlüsselwörter

Duodenaladenome - Duodenalkarzinome - ampulläre Adenome - nicht ampulläre Adenome - Therapieoptionen


Publication History

Article published online:
30 November 2022

© 2022. Thieme. All rights reserved.

Georg Thieme Verlag KG
Rüdigerstraße 14, 70469 Stuttgart, Germany

 

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