Subscribe to RSS
DOI: 10.1055/s-2003-40927
Chirurgische Therapieoptionen bei der chronischen Pankreatitis
Surgical options in chronic pancreatitisPublication History
eingereicht: 3.1.2003
akzeptiert: 2.6.2003
Publication Date:
28 July 2003 (online)

Zusammenfassung
Da die chronische Pankreatitis nicht kausal, sondern nur symptomatisch zu therapieren ist, verlangt sie eine interdisziplinäre Behandlung. Die Patienten benötigen häufig eine medikamentöse Therapie. Relevante Gangobstruktionen, symptomatische Pseudozysten, Pankreaskopftumoren und therapieresistente Schmerzen erfordern häufig den Einsatz chirurgischer Verfahren. Die chrirugische Therapie kann Beschwerden und Lebensqualität bei der chronischen Pankreatitis verbessern und die Vorraussetzung für eine sozio-ökonomische Rehabilitation schaffen. Zusätzlich senkt der Eingriff langfristig die Hospitalkosten. Da in bis zu 30 % der Fälle ein Malignom diagnostisch nicht sicher auszuschließen ist, muss im Zweifel eine Resektion nach onkologischen Kriterien durchgeführt werden.
Abstract
As there is no causal therapy, treatment of chronic pancreatitis must be interdisciplinary. Patients often need a complex medication. Relevant obstructions of the duct, symptomatic pseudocysts, tumor masses of the pancreatic head and therapy-resistant pain frequently require surgical intervention. Surgical therapy can better medical condition and afford good conditions for social rehabilitation. In addition disease-specific costs decrease on long term. As there is a diagnostic failure up to 30 % excluding a malignant disease an oncologic resection is indicated in case of doubt.
Literatur
- 1
Adam U, Makowiec F, Riediger H, Benz S, Liebe S, Hopt U T.
Pankreasleckage nach Pankreasresektion. Eine Analyse von 345
operierten
Patienten.
Chirurg.
2002;
73
466-473
Reference Ris Wihthout Link
- 2
Baron T H, Harewood G C, Morgan D E, Yates M R.
Outcome differences after endoscopic drainage of pancreatic
necrosis, acute pancreatic pseodocysts and chronic pancreatic
pseudocysts.
Gastrointest
Endosc.
2002;
56
7-17
Reference Ris Wihthout Link
- 3
Bednarz W, Olewinski R.
The influence of chronic pancreatitis on carcinogenesis: an
experimental study in rats.
Eur J Gastroenterol
Hepatol.
2002;
14
671-677
Reference Ris Wihthout Link
- 4
Beger H G, Schlosser W, Friess H M, Büchler M W.
Duodenum-preserving head resection in chronic pancreatitis
changes natural course of the disease: a single-center 26-year
experience.
Ann
Surg.
1999;
230
512-519
Reference Ris Wihthout Link
- 5
Byrne R L, Gompertz R H, Venables C W.
Surgery for chronic pancreatitis: a review of 12 years
experience.
Ann R Coll Surg
Engl.
1997;
79
405-409
Reference Ris Wihthout Link
- 6
De Palma G D, Galloro G, Puzziello A, Mansone S, Persico G.
Endoscopic drainage of pancreatic pseudocysts: a long-term
follow-up study of 49
patients.
Hepatogastroenterology.
2002;
49
1113-1115
Reference Ris Wihthout Link
- 7
Evans J D, Wilson P G, Carver. et al .
Outcome of surgery for chronic pancreatitis.
Br J
Surg.
1997;
84
624-629
Reference Ris Wihthout Link
- 8
Howard T J, Jones J W, Sherman S, Fogel E, Lehman G A.
Impact of pancreatic head resection on direct medical costs
in patients with chronic pancreatitis.
Ann
Surg.
2001;
234
661-667
Reference Ris Wihthout Link
- 9
Hruban R H, Goggins M, Parson J, Kern S E.
Progression model for pancreatic cancer.
Clin
Cancer
Res.
1999;
6
2969-2972
Reference Ris Wihthout Link
- 10
Hutchins R R, Hart R S, Pacifico M, Bradley N J, Williamson R C.
Long-term results of distal pancreatectomy for chronic
pancreatitis in 90 patients.
Ann
Surg.
2002;
236
612-618
Reference Ris Wihthout Link
- 11
Ikenberry S O, Sherman S, Hawwes R H, Smith M, Lehman G A.
The occlusion rate of pancreatic
stents.
Gastrointest
Endosc.
1994;
40
611-613
Reference Ris Wihthout Link
- 12
Kinoshita H, Hara M, Hashimoto M. et al .
Surgical treatment for chronic pancreatitis: results of
pancreatic duct drainage operation and pancreatic resection.
Kurume
Med
J.
2002;
49
41-46
Reference Ris Wihthout Link
- 13
Kozarek R A, Ball T J, Patterson D J, Brandabur J J, Traverso L W, Raltz S.
Endoscopic pancreatic duct sphincterotomy: indications,
technique, and analysis of results.
Gastrointest
Endosc.
1994;
40
592-598
Reference Ris Wihthout Link
- 14 Lankisch P G. Natural course of chronic pancreatitis. New York:
de Gruyter In: Izbicki JR, Binmoeller KF, Soehendra N,
editors. Chronic Pancreatitis. An interdisciplinary
approach 1997: 1-15
Reference Ris Wihthout Link
- 15
Lankisch P G, Assmus C, Maisonneuve P, Lowenfels A B.
Epidemiology of pancreatic diseases in Luneburg County. A
study in a defined german
population.
Pancreatology.
2002;
2
469-477
Reference Ris Wihthout Link
- 16
Lowenfels A B, Maisonneuve P.
Epidemiologic and etiologic factors of pancreatic
cancer.
Hematol Oncol Clin
North.
2002;
16
1-16
Reference Ris Wihthout Link
- 17
Malka D, Hammel P, Maire F, Rufat P, Madeira I, Pessione F, Levy P, Ruszniewski P.
Risk of pancreatic adenocarcinoma in chronic
pancreatitis.
Gut.
2002;
51
849-852
Reference Ris Wihthout Link
- 18
Olah A, Belagyi T, Issekutz A.
Surgical aspects of histologically unproven space-occupying
lesions of the pancreas hea.
uctus Magy
Seb.
2002;
55
24-26
Reference Ris Wihthout Link
- 19
Sakorafas G H, Farnell M B, Nagorney D M, Sarr M G, Rowland C M.
Pancreatoduodenectomy for chronic pancreatitis in 105
patients.
Arch
Surg.
2000;
135
517-523
Reference Ris Wihthout Link
- 20
Sakorafas G H, Sarr M G.
Changing trends in operations for chronic pancreatitis: A
22-year experience.
Eur J
Surg.
2000;
166
633-637
Reference Ris Wihthout Link
- 21
Schäfer M, Müllhaupt B, Clavien P A.
Evidence-based pancreatic head resection für pancreatic
cancer and chronic pancreatitis.
Ann
Surg.
2002;
236
137-148
Reference Ris Wihthout Link
- 22
Sohn T A, Campbell K A, Pitt H A. et al .
Quality of life and long-term survival after surgery for
chronic pancreatitis.
J Gastrointest
Surg.
2000;
4
355-364
Reference Ris Wihthout Link
- 23
Tinto A, Lloyd D A, Kang J Y. et al .
Acute and chronic pancreatitis - diseases on the rise:
a study of hospital admissions in England
1989/90 - 1999/2000.
Aliment Pharmacol
Ther.
2002;
16
2097-2105
Reference Ris Wihthout Link
- 24
Traverso L W, Kozarek R A.
Pancreatectoduodenectomy for chronic pancreatitis: anatomic
selection criteria and subsequent long-term outcome analysis.
Ann
Surg.
1997;
226
429-435
Reference Ris Wihthout Link
- 25
Usatoff V, Brancatisamo R, Williamson R C.
Operative treatment of pseudocysts in patinets with chronic
pancreatitis.
Br J
Surg.
2000;
87
1494-1499
Reference Ris Wihthout Link
- 26
Yamaguchi K, Yokohata K, Nakano K. et al .
Which is less invasive pancreatic head resection: PD, PPPD,
or DPPHR?.
Dig Dis
Sci.
2001;
46
282-288
Reference Ris Wihthout Link
Dr. med. Carsten Johannes Krones
Chirurgische Universitäts- und Poliklinik der RWTH
Aachen
Pauwelstraße 30
52074 Aachen
Phone: 0241/8089501
Fax: 0241/8082417
Email: Carsten.Krones@post.rwth-aachen.de
