Extrahepatische Gallenwegstumoren: aktueller Stand der palliativen Therapie

Zusammenfassung

Einleitung: Die Dekompression der Gallenwege ist vorrangiges Therapieziel in der palliativen Situation, weil so infektiöse Komplikationen und die sekundäre billiäre Zirrhose verhindert sowie die Lebensqualität besser erhalten werden können.

Kernaussagen: Derzeit scheint in der palliativen Situation die photodynamische Therapie mit Einlage von Endoprothesen am besten belegt zu sein.

Methode: Selektive Literaturübersicht kombiniert mit eigenen klinischen Erfahrungen.

Schlussfolgerung: Die therapeutischen Mittel sollten sich ferner der Ausbreitung und dem Stadium anpassen: Bei lokal fortgeschrittener oder progredienter Erkrankung (Stadium III) ein lokal-ablatives Verfahren, bei systemischem Progress (Stadium IV) die systemische Chemotherapie.

Abstract

Introduction: Decompression of bile ducts is the priority objective in the non-curative stage of hilar cholangiocarcinoma. Only this will prevent or slow down infectious complications and secondary biliary cirrhosis thereby sustaining the quality of life.

Key Statements: At present, photodynamic therapy combined with insertion of an endoprosthesis seems to be best documented and most appropriate therapy.

Methods: Data from a selective literature search combined with our clinical experience were evaluated.

Conclusions: Therapeutic measures should match the dissemination and stage of the tumor: in locally advanced or progressing disease (stage III) a local ablating therapy, in systemically progressing disease (stage IV) systemic chemotherapy should be utilised.

Schlüsselwörter

Gallenwegstumor - Klatskin Tumor - palliative Therapie - photodynamische Therapie

Key words

Cholangiocarcinoma - Klatskin tumour - palliation therapy - photodynamic therapy

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