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01.12.2006 | Leitthema

Stellenwert spezieller palliativer Therapieverfahren beim extrahepatischen Gallengangskarzinom

Gallengangsstents, photodynamische Therapie, operative Umgehungsanastomosen

verfasst von: PD Dr. M. Wiedmann, J. Hauss, H. Witzigmann, J. Mössner

Erschienen in: Die Onkologie | Ausgabe 12/2006

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Zusammenfassung

Karzinome der Gallenwege sind seltene Tumoren des Gastrointestinaltrakts mit in den letzten Jahren zunehmender Inzidenz. Beim inoperablen extrahepatischen Gallengangskarzinom ist die endoskopische Therapie von zentraler Bedeutung. Sie ist wenig invasiv, bessert die Symptome des Verschlussikterus, beugt Komplikationen vor und ist wesentlicher Bestandteil der Cholangitistherapie. Hauptkomplikation ist der Stentverschluss mit nachfolgender Cholangitis. Eine prophylaktische Langzeitantibiose hat sich nicht bewährt. Technische Fragen bezüglich Stentmaterial, Anzahl und Platzierung der Stents sind noch nicht abschließend geklärt. Die chirurgische Cholangiojejunostomie mit dem Segment-III-Gallengang bei Klatskin-Tumoren und die Hepatikojejunostomie bei distalen Gallengangskarzinomen sind wegen der hohen Erfolgsrate der Stenttherapie nur selten indiziert. Die photodynamische Therapie (PDT) verbessert das Überleben und die Lebensqualität bei Patienten mit inoperablen hilären Tumoren und stellt mittlerweile eine etablierte Therapieform dar.
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Metadaten
Titel
Stellenwert spezieller palliativer Therapieverfahren beim extrahepatischen Gallengangskarzinom
Gallengangsstents, photodynamische Therapie, operative Umgehungsanastomosen
verfasst von
PD Dr. M. Wiedmann
J. Hauss
H. Witzigmann
J. Mössner
Publikationsdatum
01.12.2006
Verlag
Springer-Verlag
Erschienen in
Die Onkologie / Ausgabe 12/2006
Print ISSN: 2731-7226
Elektronische ISSN: 2731-7234
DOI
https://doi.org/10.1007/s00761-006-1134-3

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