Entwicklung der Pankreaschirurgie in den letzten 10 Jahren

Zusammenfassung

Die Pankreaschirurgie hat sich in den vergangenen Jahren in großem Umfang weiterentwickelt. Spezialisierte Zentrumsbildung mit interdisziplinärer Expertise hat zu einer Verbesserung der Patientenbetreuung und Senkung der perioperativen Morbidität und Mortalität geführt. Im Hinblick auf die evidenzbasierte Medizin wurden internationale Konsensusdefinitionen zur Morbidität und qualitativ hochwertige Studien, systematische Review-Arbeiten sowie Metaanalysen zu vielen Aspekten der Pankreaschirurgie publiziert. Bei akuter Pankreatitis hat sich ein Paradigmenwechsel vom operativen zum konservativen Vorgehen vollzogen, bei der chronischen Pankreatitis haben die parenchymsparenden Resektionsverfahren eine weite Verbreitung gefunden. Das Management zystischer Pankreasveränderungen – insbesondere der intraduktal papillär-muzinösen Neoplasien (IPMN) – nimmt einen großen Stellenwert in der chirurgischen Praxis ein. Beim Pankreaskarzinom haben – über die chirurgisch-technischen Aspekte hinaus – große internationale Multicenterstudien die herausragende Bedeutung der adjuvanten Therapie gezeigt.

Abstract

Pancreatic surgery has undergone significant progress during recent years. Specialised centres with interdisciplinary expertise have led to improved patient care with decreased morbidity and mortality. Regarding evidence-based medicine, consensus definitions on morbidity as well as high-quality studies, systematic reviews and meta-analyses on different topics of pancreatic surgery have been published. In acute pancreatitis paradigms have shifted towards conservative management, in chronic pancreatitis parenchyma-sparing resection techniques have widely become accepted. Management of cystic lesions – especially intraductal papillary mucinous neoplasms (IPMN) – has attracted great interest in surgical practice. In pancreatic cancer treatment not only surgical resection techniques have improved but also the central impact of adjuvant treatment has been demonstrated in large multicentre trials.

Schlüsselwörter

Pankreaschirurgie - Pankreaskarzinom - Pankreaskopfresektion - IPMN - chronische Pankreatitis

Key words

pancreatic surgery - pancreatic carcinoma - pancreatic head resection - IPMN - chronic pancreatitis

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