Skip to main content
SpringerLink
Log in

Palliative Chirurgie des Pankreaskarzinoms

  • Chapter
  • First Online:
Palliative Viszeralchirurgie

Zusammenfassung

Das Pankreaskarzinom ist durch seine hohe Aggressivität und schlechte Prognose gekennzeichnet. Trotz kurativer Intention bleiben die meisten Resektionen palliativer Natur. Auf der Grundlage der präoperativen Bildgebung muss eine R2-Resektion vermieden werden. Zur Palliation typischer Symptome wie obstruktiver Cholestase, Magenausgangsstenose und Schmerzen stehen spezifische chirurgische, jedoch auch interventionelle und endoskopische Behandlungsoptionen zur Verfügung. Die Auswahl erfolgt hier im Hinblick auf die aktuelle Studienlage sowie die individuellen patientenseitigen Voraussetzungen.

This is a preview of subscription content, log in via an institution to check access.

Access this chapter

Log in via an institution
Chapter
USD 29.95
Price excludes VAT (USA)
  • Available as PDF
  • Read on any device
  • Instant download
  • Own it forever
eBook
USD 69.99
Price excludes VAT (USA)
  • Available as EPUB and PDF
  • Read on any device
  • Instant download
  • Own it forever
Hardcover Book
USD 89.99
Price excludes VAT (USA)
  • Durable hardcover edition
  • Dispatched in 3 to 5 business days
  • Free shipping worldwide - see info

Tax calculation will be finalised at checkout

Purchases are for personal use only

Institutional subscriptions

Literatur

  • Arcidiacono, Paolo G., Giliola Calori, Silvia Carrara, et al. 2011. Celiac plexus block for pancreatic cancer pain in adults. Cochrane Database Syst Rev (3):CD007519

    Google Scholar 

  • Bhatnagar S, Joshi S, Rana SPS, Mishra S et al (2014) Bedside ultrasound-guided celiac plexus neurolysis in upper abdominal cancer patients: a randomized, prospective study for comparison of percutaneous bilateral paramedian vs. unilateral paramedian needle-insertion technique. Pain Practice 14(2):E63–E68

    Article  Google Scholar 

  • Bliss LA, Eskander MF, Kent TS et al (2016) Early surgical bypass versus endoscopic stent placement in pancreatic cancer. HPB 18(8):671–677

    Article  Google Scholar 

  • Bockhorn M, Uzunoglu FG, Adham M et al (2014) Borderline resectable pancreatic cancer: a consensus statement by the International Study Group of Pancreatic Surgery (ISGPS). Surgery 155(6):977–988

    Article  Google Scholar 

  • Crippa S, Bittoni A, Sebastiani E et al (2016) Is there a role for surgical resection in patients with pancreatic cancer with liver metastases responding to chemotherapy? Eur J Surg Oncol. https://doi.org/10.1016/j.ejso.2016.06.398

    Article  CAS  Google Scholar 

  • Demir IE, Friess H, Ceyhan GO (2012) Nerve-cancer interactions in the stromal biology of pancreatic cancer. Front Physiol 3. https://doi.org/10.3389/fphys.2012.00097

  • Doi S, Yasuda I, Kawakami H et al (2013) Endoscopic ultrasound-guided celiac ganglia neurolysis vs. celiac plexus neurolysis: a randomized multicenter trial. Endoscopy 45(5):362–369

    Article  CAS  Google Scholar 

  • Esposito I, Kleeff J, Bergmann F et al (2008) Most pancreatic cancer resections are R1 resections. Ann Surg Oncol 15(6):1651–1660

    Article  Google Scholar 

  • Fleming JB, Roife D, Dai B et al (2016) Ex vivo testing of patient-derived xenografts mirrors the clinical outcome of patients with pancreatic ductal adenocarcinoma. Clin Cancer Res. https://doi.org/10.1158/1078-0432.CCR-15–2936

  • Frigerio I, Regi P, Giardino A et al (2017) Downstaging in stage IV pancreatic cancer: a new population eligible for surgery? Ann Surg Oncol. https://doi.org/10.1245/s10434-017-5885-4

    Article  Google Scholar 

  • Fujii T, Yamada S, Suenaga M et al (2014) Preoperative internal biliary drainage increases the risk of bile juice infection and pancreatic fistula after pancreatoduodenectomy: a prospective observational study. Pancreas. https://doi.org/10.1097/MPA.0000000000000265

  • Glazer ES, Hornbrook MC, Krouse RS (2014) A meta-analysis of randomized trials: immediate stent placement vs. surgical bypass in the palliative management of malignant biliary obstruction. J Pain Symptom Manag 47(2):307–314

    Article  Google Scholar 

  • Gress F, Schmitt C, Sherman S, Ikenberry S, Lehman G (1999) A prospective randomized comparison of endoscopic ultrasound- and computed tomography-guided celiac plexus block for managing chronic pancreatitis pain. Am J Gastroenterol 94(4):900–905

    Article  CAS  Google Scholar 

  • Gurusamy, Kurinchi Selvan, Senthil Kumar Brian R. Davidson. 2013. Prophylactic gastrojejunostomy for unresectable periampullary carcinoma. Cochrane Database Syst Rev (2):CD008533

    Google Scholar 

  • Gurusamy, Kurinchi Selvan, Senthil Kumar, Brian R. Davidson Giuseppe Fusai. 2014. Resection versus other treatments for locally advanced pancreatic cancer. Cochrane Database Syst Rev (2):CD010244

    Google Scholar 

  • Hartwig W, Hackert T, Hinz U et al (2009) Multivisceral resection for pancreatic malignancies: risk-analysis and long-term outcome. Ann Surg 250(1):81–87

    Article  Google Scholar 

  • Iacono C, Ruzzenente A, Campagnaro T et al (2013) Role of preoperative biliary drainage in jaundiced patients who are candidates for pancreatoduodenectomy or hepatic resection: highlights and drawbacks. Ann Surg 257(2):191–204

    Article  Google Scholar 

  • Jeurnink SM, Steyerberg EW, van Hooft JE et al (2010) Surgical gastrojejunostomy or endoscopic stent placement for the palliation of malignant gastric outlet obstruction (SUSTENT Study): A multicenter randomized trial. Gastrointest Endosc 71(3):490–499

    Article  Google Scholar 

  • Johnson CD, Berry DP, Harris S et al (2009) An open randomized comparison of clinical effectiveness of protocol-driven opioid analgesia, celiac plexus block or thoracoscopic splanchnicectomy for pain management in patients with pancreatic and other abdominal malignancies. Pancreatology 9(6):755–763

    Article  CAS  Google Scholar 

  • Kneuertz PJ, Cunningham SC, Cameron JL et al (2011) Palliative surgical management of patients with unresectable pancreatic adenocarcinoma: trends and lessons learned from a large, single institution experience. J Gastrointest Surg 15(11):1917–1927

    Article  Google Scholar 

  • Kofokotsios A, Papazisis K, Andronikidis I et al (2015) Palliation with endoscopic metal stents may be preferable to surgical intervention for patients with obstructive pancreatic head adenocarcinoma. Int Surg 100(6):1104–1110

    Article  Google Scholar 

  • Lavu H, Lengel HB, Sell NM et al (2015) A prospective randomized double blind placebo controlled trial on the efficacy of ethanol celiac plexus neurolysis in patients with operable pancreatic and periampullary adenocarcinoma. J Am Coll Surg 220(4):497–508

    Article  Google Scholar 

  • Lillemoe KD, Cameron JL, Kaufman HS et al (1993) Chemical splanchnicectomy in patients with unresectable pancreatic cancer. A prospective randomized trial. Ann Surg 217(5):447–457

    Article  CAS  Google Scholar 

  • McDowell BD, Chapman CG, Smith BJ et al (2015) Pancreatectomy predicts improved survival for pancreatic adenocarcinoma: results of an instrumental variable analysis. Ann Surg 261(4):740–745

    Article  Google Scholar 

  • Nagaraja V, Eslick GD, Cox MR (2014) Endoscopic stenting versus operative gastrojejunostomy for malignant gastric outlet obstruction. A systematic review and meta-analysis of randomized and non-randomized trials. J Gastrointest Oncol 5(2):92–98

    PubMed  PubMed Central  Google Scholar 

  • Navarra G, Musolino C, Venneri A et al (2006) Palliative antecolic isoperistaltic gastrojejunostomy: a randomized controlled trial comparing open and laparoscopic approaches. Surg Endosc 20(12):1831–1834

    Article  CAS  Google Scholar 

  • Rahib L, Smith BD, Aizenberg R, Rosenzweig AB et al (2014) Projecting cancer incidence and deaths to 2030: the unexpected burden of thyroid, liver, and pancreas cancers in the United States. Cancer Res 74(11):2913–2921

    Article  CAS  Google Scholar 

  • Seufferlein T, Porzner M, Becker T et al (2013) S3-guideline exocrine pancreatic cancer. Z Gastroenterol 51(12):1395–1440

    Article  CAS  Google Scholar 

  • Singh S, Sachdev AK, Chaudhary A, Agarwal AK (2008) Palliative surgical bypass for unresectable periampullary carcinoma. Hepatobil Pancreat Dis Int 7(3):308–312

    Google Scholar 

  • Strobel O, Hank T, Hinz U et al (2016) Pancreatic cancer surgery: the new R-status counts. Ann Surg. https://doi.org/10.1097/SLA.0000000000001731

    Article  Google Scholar 

  • Süleyman Ozyalçin N, Talu GK, Camlica H, Erdine S (2004) Efficacy of coeliac plexus and splanchnic nerve blockades in body and tail located pancreatic cancer pain. Eur J Pain 8(6):539–545

    Article  Google Scholar 

  • Sun H, Ma H, Hong G, Sun H, Wang J (2014) Survival improvement in patients with pancreatic cancer by decade: a period analysis of the SEER Database, 1981–2010. Sci Report 4:6747

    Article  CAS  Google Scholar 

  • Szymanski D, Durczynski A, Nowicki M, Strzelczyk J (2013) Gastrojejunostomy in patients with unresectable pancreatic head cancer – the use of roux loop significantly shortens the hospital length of stay. World J Gastroenterol 19(45):8321–8325

    Article  Google Scholar 

  • Tol JAMG, Eshuis WJ, Besselink MGH et al (2015) Non-radical resection versus bypass procedure for pancreatic cancer – a consecutive series and systematic review. Eur J Surg Oncol 41(2):220–227

    Article  CAS  Google Scholar 

  • Verbeke CS (2013) Resection margins in pancreatic cancer. Surg Clin N Am 93(3):647–662

    Article  Google Scholar 

  • Wyse JM, Carone M, Paquin SC et al (2011) Randomized, double-blind, controlled trial of early endoscopic ultrasound-guided celiac plexus neurolysis to prevent pain progression in patients with newly diagnosed, painful, inoperable pancreatic cancer. J Clin Oncol 29(26):3541–3546

    Article  Google Scholar 

  • Yamamoto KN, Yachida S, Nakamura A et al (2017) Personalized management of pancreatic ductal adenocarcinoma patients through computational modeling. Cancer Res. https://doi.org/10.1158/0008-5472.CAN-16-1208

    Article  CAS  Google Scholar 

  • Yu XZ, Li J, Fu DL et al (2014) Benefit from synchronous portal-superior mesenteric vein resection during pancreaticoduodenectomy for cancer: a meta-analysis. Eur J Surg Oncol 40(4):371–378

    Article  CAS  Google Scholar 

Download references

Author information

Authors and Affiliations

  1. Klinik für Chirurgie, Universitätsklinikum Schleswig-Holstein, Campus Lübeck, Lübeck, Deutschland

    Ulrich F. Wellner & Tobias Keck

Authors
  1. Ulrich F. Wellner
    View author publications

    You can also search for this author in PubMed Google Scholar

  2. Tobias Keck
    View author publications

    You can also search for this author in PubMed Google Scholar

Corresponding author

Correspondence to Ulrich F. Wellner .

Editor information

Editors and Affiliations

  1. Universitätsmedizin Göttingen, Klinik für Allgemein-, Viszeral- und Kinderchirurgie, Göttingen, Germany

    Michael Ghadimi

  2. Klinik für Allgemein, Viszeral- und Gefäßchirurgie, DRK-Kliniken Nordhessen, Kassel, Germany

    Kia Homayounfar

  3. Klinik und Poliklinik für Allgemein-, Universitätsklinikum Bonn Klinik und Poliklinik für Allgemein-, Bonn, Germany

    Jörg C. Kalff

Rights and permissions

Reprints and permissions

Copyright information

© 2019 Springer-Verlag GmbH Deutschland, ein Teil von Springer Nature

About this chapter

Check for updates. Verify currency and authenticity via CrossMark

Cite this chapter

Wellner, U.F., Keck, T. (2019). Palliative Chirurgie des Pankreaskarzinoms. In: Ghadimi, M., Homayounfar, K., Kalff, J. (eds) Palliative Viszeralchirurgie. Springer, Berlin, Heidelberg. https://doi.org/10.1007/978-3-662-57362-4_19

Download citation

  • DOI: https://doi.org/10.1007/978-3-662-57362-4_19

  • Published:

  • Publisher Name: Springer, Berlin, Heidelberg

  • Print ISBN: 978-3-662-57361-7

  • Online ISBN: 978-3-662-57362-4

  • eBook Packages: Medicine (German Language)

Publish with us

Policies and ethics

Search

Navigation