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Pankreaslinksresektion mit Splenektomie und Resektion des Truncus coeliacus bei einem Pankreaskorpuskarzinom mit Infiltration des Truncus coeliacus

Distal Pancreatectomy with Splenectomy and En Bloc Resection of the Celiac Trunk for Locally Advanced Cancer of the Pancreatic Body with Infiltration of the Celiac Trunk

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Zusammenfassung

Hintergrund:

Das lokal fortgeschrittene Karzinom des Pankreaskorpus mit Infiltration des Truncus coeliacus und seiner Abgänge wird häufig als irresektabler Befund eingestuft. Als ein neues Konzept zur kurativen Behandlung dieser Tumoren wurde die Pankreaslinksresektion einschließlich der Resektion des Truncus coeliacus beschrieben.

Fallbeschreibung:

Berichtet wird über eine 61-jährige Patientin, die wegen eines Pankreaskorpuskarzinoms mit Infiltration des Truncus coeliacus eine Pankreaslinksresektion mit Splenektomie und Resektion des Truncus coelia cus erhielt. Um die arterielle Versorgung der Leber zu sichern, erfolgte präoperativ die Embolisation des Truncus coeliacus.

Schlussfolgerung:

Die distale Pankreatektomie mit En-bloc-Resektion des Truncus coeliacus eignet sich bei gefäßinfiltrierenden Tumoren des Pankreaskorpus zur Erreichung einer hohen Resektabilitätsrate und bietet somit einen kurativen Behandlungsansatz. Eine differenzierte Auswahl der Patienten und die Einleitung einer adjuvanten Chemotherapie könnten die Überlebensrate dieser Patientengruppe deutlich verbessern.

Abstract

Background:

Locally advanced cancer of the body of the pancreas with infiltration of the celiac trunk and its branches is often considered an unresectable disease. Distal pancreatectomy with resection of the celiac trunk was described as a new concept for the curative treatment of these tumors.

Case Report:

The case of a 61-year-old female patient is reported, who underwent distal pancreatectomy with splenectomy and resection of the celiac trunk for locally advanced cancer of the pancreatic body with infiltration of the celiac trunk. The celiac trunk was embolized preoperatively in order to assure arterial perfusion of the liver.

Conclusion:

Distal pancreatectomy with en bloc resection of the celiac trunk offers a high resectability rate and thus a curative option for locally advanced cancer of the pancreatic body with vascular invasion. The optimization of patient selection and the development of effective adjuvant chemotherapy could significantly improve the survival of patients subjected to this operation.

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Authors and Affiliations

  1. Klinik für Allgemein-, Visceral- und Transplantationschirurgie, Charité – Universitätsmedizin Berlin, Campus Virchow-Klinikum, Berlin, Germany

    Andreas Andreou, Matthias Glanemann, Olaf Guckelberger & Peter Neuhaus

  2. Klinik für Strahlenheilkunde, Charité – Universitätsmedizin Berlin, Campus Virchow-Klinikum, Berlin, Germany

    Timm Denecke, Christian Grieser & Petr Podrabsky

  3. Klinik für Allgemein-, Visceral- und Transplantationschirurgie, Charité – Universitätsmedizin Berlin, Campus Virchow-Klinikum, Augustenburger Platz 1, 13353, Berlin, Germany

    Andreas Andreou

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  1. Andreas Andreou
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  2. Matthias Glanemann
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  3. Olaf Guckelberger
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  7. Peter Neuhaus
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Correspondence to Andreas Andreou.

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Andreou, A., Glanemann, M., Guckelberger, O. et al. Pankreaslinksresektion mit Splenektomie und Resektion des Truncus coeliacus bei einem Pankreaskorpuskarzinom mit Infiltration des Truncus coeliacus. Med Klin 105, 227–231 (2010). https://doi.org/10.1007/s00063-010-1031-9

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