Interventionen am Pankreas: Biopsie, Drainage, Nekrosektomie - Sicht des Radiologen

Zusammenfassung

Die vorliegende Arbeit ist eine Übersichtsarbeit, die die Möglichkeiten der interventionellen Radiologie von Pankreaserkrankungen diagnostisch und therapeutisch aufzeigt. Besonderen Wert wird auf die Beschreibung der interventionell radiologischen Technik, ihren sinnvollen Einsatz und ihre Grenzen gelegt.

Pancreatic interventions: Biopsies, drainages, necrosectonies from a radiological standpoint

The following publication is an overview looking at diagnostic and therapeutic possibilities related to interventional procedures for diseases of the pancreas. We emphasize the description of the technique and show meaningful indications and limitations.

Schlüsselwörter

Pankreas - Biopsie - Drainage - Pankreatitis - Pseudozyste

Key words

Pancreas - Biopsy - Drainage - Pancreatitis - Pseudcyst

Literatur

• 1 Wittenberg J, Müller P R, Ferrucci J T Jr. et al . Percutaneous core biopsy of abdominal tumors using 22 gauge needles: Further observations.  AJR. 1982;  139 75-80
• 2 Alexander D J, Fowler R, McMahon M J. Treatment of acute pancreatitis caused by calculous obstruction of the pancreatic duct by ultrasound guided percutaneous drainage.  Pancreas. 1992;  7 105-108
• 3 Warshaw A, Rutledge P L. Cystic tumors mistaken for pancreatic pseudocysts.  Ann Surg. 1987;  205 393-398
• 4 Mueller P R. Primer of diagnostic imaging. Edited by: Weissleder R, Rieumont MJ, Wittenberg J St. Louis, Mosby-Year Book, 1997
• 5 Lewandrowski K B, Lee J, Southern J, Centeno B, Warshaw A. Cyst fluid analysis in the differential diagnosis of pancreatic cysts: A new approach to the preoperative assessment of pancreatic cystic lesions.  AJR. 1995;  164 815-819
• 6 Klose K C, Günther R W. Perkutane diagnostische Punktionen: CT-gesteuerte Punktionen. In: Interventionelle Radiologie. Günter RW, Thelen M (Hrsg) Stuttgart, New York, Thieme Verlag, 1988
• 7 Tatsuta M, Yamamoto R, Yamamura H, Okuda S, Tamura H. Cytologic examination and CEA measurement in aspirated pancreatic material collected by percutaneous fine-needle biopsy under ultrasonic guidance for the diagnosis of pancreatic carcinoma.  Cancer. 1983;  52 693-698
• 8 Ihse I, Toregard B M, Akerman M. Intraoperative fine needle aspiration cytology in pancreatic lesions.  Ann Surg. 1979;  190 732-734
• 9 van Sonnenberg E, Wittich G R, Casola G. et al . Complicated pancreatic inflammatory disease: Diagnostic and therapeutic role of interventional radiology.  Radiology. 1985;  155 335-340
• 10 Centeno B, Lewandrowski K B, Warshaw A, Compton C C, Southern J F. Cyst fluid cytologic analysis in the differential diagnosis of pancreatic cystic lesions.  Am J Clin Pathol. 1994;  101 483-487
• 11 Lewandrowski K B, Southern J F, Pins M R, Compton C C, Warshaw A. Cyst fluid analysis in the differential diagnosis of pancreatic cysts. A comparison of pseudocysts, serous cystadenomas, mucinous cystic neoplasms, and mucinous cystadenocarcinoma.  Ann Surg. 1993;  217 41-47
• 12 Coel M, Niwayama N G. Safety of percutaneous fine needle pancreatic biopsy: A porcine model.  Invest Radiol. 1978;  13 547-549
• 13 Ferrucci JT  Jr, Wittenberg J, Müller P R. et al . Diagnosis of abdominal malignancy by radiology fine-needle aspiration biopsy.  AJR. 1980;  134 323-330
• 14 Goldstein H M, Zornoza J, Wallace S. et al . Percutaneous fine needle aspiration biopsy of pancreatic and other abdominal masses.  Radiology. 1977;  123 319-322
• 15 Evans W K, Ho C S, McJoughlin M J, Tao L C. Fatal necrotizing pancreatitis following fine needle biopsy of the pancreas.  Radiology. 1981;  141 61-62
• 16 O’Malley V P, Cannon J P, Postier R G. Pancreatic pseudocysts: Cause, therapy, and results.  Am J Surg. 1985;  150 680-682
• 17 Siegelman S S, Copeland B E, Saba G P. et al . CT of fluid collections associated with pancreatitis.  AJR. 1980;  134 1121-1132
• 18 Grace P A, Williamson R C. Modern management of pancreatic pseudocysts.  Br J Surg. 1993;  80 573-581
• 19 Gumaste U V, Dave P B. Pancreatic pseudocyst drainage - the needle or the scalpel?.  J Clin Gastroenterol. 1991;  13 500-505
• 20 Lee M J, Rattner D W, Legemate D A. et al . Acute complicated pancreatitis: Redefining the role of interventional radiology.  Radiology. 1992;  183 171-174
• 21 Freeny P C, Lewis G P, Traverso L W, Ryan J A. Infected pancreatic fluid collections: Percutaneous catheter drainage.  Radiology. 1988;  167 435-441
• 22 Steiner E, Mueller P R, Hahn P F. et al . Complicated pancreatic abscesses: Problems in interventional management.  Radiology. 1988;  167 443-446
• 23 Karlson K B, Martin E C, Fankuchen E I. et al . Percutaneous drainage of pancreatic pseudocysts and abscesses.  Radiology. 1982;  142 619-624
• 24 Mueller P R, van Sonnenberg E, Ferrucci JT  Jr. Percutaneous drainage of 250 abdominal abscesses and fluid collections. Part II: Current procedural concepts.  Radiology. 1984;  151 343-347
• 25 Bradley E L, Clements J L Jr, Gonzalez A C. The natural history of pancreatic pseudocysts: A unified concept of management.  Am J Surg. 1979;  137 135-141
• 26 Yeo C J, Bastidas J A, Lynch-Nyhan A. et al . The natural history of pancreatic pseudocysts documented by computed tomography.  Surg Gynecol Obstet. 1990;  170 411-417
• 27 Gussenbauer C. Zur operativen Behandlung der Pankreaszysten.  Arch Klein Chir. 1883;  29 355-394
• 28 Freeny P C. Percutaneous management of pancreatic fluid collections.  Baillieres Clin Gastroenterol. 1992;  6 259-272
• 29 D’Egidio A, Schein M. Pancreatic pseudocysts: A proposed classification and its management implications.  Br J Surg. 1991;  78 981-984
• 30 van Sonnenberg E, Wittich G R, Casola G. et al . Percutaneous drainage of infected and noninfected pancreatic pseudocysts: Experience in 101 cases.  Radiology. 1989;  170 757-761
• 31 Barkin J S, Reiner D K, Deutch E. Sandostatin for control of catheter drainage of pancreatic pseudocyst.  Pancreas. 1991;  6 245-248
• 32 Beger H G, Rau B, Mayer J. et al . Natural course of acute pancreatitis.  World J Surg. 1997;  21 130-135
• 33 Banks P. Acute pancreatitis: Medical and surgical management.  Am J Gastroenterol. 1994;  89 78-85
• 34 Beger H G, Bittner R, Block S. et al . Bacterial contamination of pancreatic necrosis: A prospective study.  Gastroenterology. 1986;  91 433-438
• 35 Rau B, Uhl W, Bücheler M, Beger H G. Surgical treatment of infected necrosis.  World J Surg. 1997;  21 155-161
• 36 Freeny P C, Hauptmann E, Althaus S J, Traverso L W, Sinanan M. Percutaneous ct-guided catheter drainage of infected acute necrotizing pancreatitis: Technique and results.  AJR. 1998;  170 969-975
• 37 Mueller P R. Percutanous drainage of pancreatic necrosis: Is it ecstasy or agony?.  AJR. 1998;  170 976-977
• 38 Hancke S, Henriksen F W. Percutaneous pancreatic cystogastrostomy guided by ultrasound scanning and gastroscopy.  Br J Surg. 1985;  72 916-917

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