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Die Innere Medizin
Erschienen in: Der Internist 12/2016

07.11.2016 | Zytostatische Therapie | CME

Diagnostik und Therapie des cholangiozellulären Karzinoms

verfasst von: Prof. Dr. L. Zender, N. P. Malek

Erschienen in: Die Innere Medizin | Ausgabe 12/2016

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Zusammenfassung

Das cholangiozelluläre Karzinom (CCA) ist das zweithäufigste primäre Lebermalignom. CCA werden meist in einem fortgeschrittenen Stadium diagnostiziert. Das Gesamtüberleben ist schlecht. Die histologische Sicherung des Tumors kann über eine Biopsie oder eine Bürstenzytologie der Gallengänge erfolgen. Es werden distale, perihiläre und intrahepatische Cholangiokarzinome unterschieden. Die anatomische Lage bestimmt die diagnostische und therapeutische Strategie. Zu Beginn eines jeden Therapiealgorithmus steht bei Cholestase die endoskopische oder perkutane Sicherung des Galleabflusses im Vordergrund. Abhängig vom Tumorstadium steht als chirurgische Optionen eine radikale Resektion mit Hepatikojejunostomie oder im Einzelfall eine Lebertransplantation zur Verfügung. Bei intrahepatischen oder distalen CCA hat Letztere keinen Stellenwert. In der palliativen Therapiesituation führt eine Chemotherapie mit Gemcitabin und Cisplatin im Mittel zu einer signifikanten Überlebenszeitverlängerung.
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Metadaten
Titel
Diagnostik und Therapie des cholangiozellulären Karzinoms
verfasst von
Prof. Dr. L. Zender
N. P. Malek
Publikationsdatum
07.11.2016
Verlag
Springer Medizin
Erschienen in
Die Innere Medizin / Ausgabe 12/2016
Print ISSN: 2731-7080
Elektronische ISSN: 2731-7099
DOI
https://doi.org/10.1007/s00108-016-0128-5

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