Endoskopische und radiologisch-interventionelle Therapie von malignen und benignen Gallengangstenosen

D. Hartmann; R. Jakobs; D. Schilling; J. F. Riemann

doi:10.1055/s-2003-44801

Zentralblatt für Chirurgie, Table of Contents

Zentralbl Chir 2003; 128(11): 936-943
DOI: 10.1055/s-2003-44801

Originalarbeiten und Übersichten

Endoskopische und radiologisch-interventionelle Therapie von malignen und benignen Gallengangstenosen

Endoscopic and Radiological Interventional Therapy of Benign and Malignant Bile Duct StenosesD. Hartmann¹ , R. Jakobs ¹ , D. Schilling¹ , J. F. Riemann¹

¹Medizinische Klink C, Gastroenterologie, Hepatologie, Diabetologie, Klinikum der Stadt Ludwigshafen gGmbH

Abstract

Zusammenfassung

Seit der Entwicklung der therapeutischen endoskopisch-retrograden Cholangiopankreatikographie und der perkutanen Cholangiodrainage stehen zwei nichtoperative Therapiemöglichkeiten zur Behandlung von benignen und malignen Gallengangstenosen zur Verfügung. Stenosen unterschiedlicher Ätiologie, die nach Abschluss der Diagnostik als benigne eingestuft werden, können in 50 bis 90 % aller Fälle mit gutem langfristigen Dilatationserfolg behandelt werden. Ziel der palliativen Drainagetherapie bei malignen Gallengangstenosen ist die Verbesserung der Lebensqualität durch Beseitigung des Ikterus und des damit verbundenen Pruritus. Zudem kann der Ausbildung einer Cholangitis sowie einer drohenden Verschlechterung der hepatischen Funktion vorgebeugt werden. Durch die photodynamische Therapie kann wahrscheinlich bei cholangiozellulären Karzinomen eine Verbesserung der Lebensqualität und der Prognose erreicht werden.

Abstract

Since the development of therapeutic endoscopic retrograde cholangiopancreatography and percutaneous transhepatic biliary drainage, two non-interventional therapeutic options are available for the treatment of benign and malignant bile duct stenosis. Stenosis of different aetiology, which can be classified as benign after completion of the diagnoses, can be treated with good long-term dilation success in 50 to 90 % of all cases. The aim of palliative drainage therapy of malignant bile duct stenosis is the improvement of quality of life by removing the jaundice and the pruritus. In addition, the development of cholangitis as well as impending deterioration of the hepatic function can be prevented. By photodynamic therapy it seems possible to achieve an improvement of quality of life and of the prognosis in cholangiocarcinoma.

Schlüsselwörter

Gallengangstenose - endoskopische retrograde Cholangiopankreatikographie (ERCP) - perkutane transhepatische Cholangiodrainage (PTCD) - Verschlussikterus - Drainage - photodynamische Therapie

Key words

Bile duct stenosis - endoscopic retrograde cholangiopancreatography (ERCP) - percutaneous transhepatic cholangiography (PTCD) - obstructive jaundice - drainage - photodynamic therapy

Full Text

References

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