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Komplikationen der minimal-invasiven Pankreasresektion bei neuroendokrinen Pankreastumoren

Complications of minimally invasive pancreas resection for pancreatic neuroendocrine tumors

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Zusammenfassung

Hintergrund

Die laparoskopische Chirurgie gewinnt auch bei Pankreasresektionen zunehmend an Bedeutung. Hiervon ist auch die laparoskopische Resektion neuroendokriner Pankreastumoren betroffen.

Fragestellung

Welche Komplikationen treten bei der laparoskopischen Resektion neuroendokriner Pankreastumoren auf und wie unterscheiden sie sich von Komplikationen bei offenem Vorgehen.

Material und Methode

Fallserien und Metaanalysen der letzten Jahre wurden ausgewertet und die Ergebnisse werden diskutiert.

Ergebnisse

Die Rate und die Art der Komplikationen unterscheiden sich nicht wesentlich zwischen dem laparoskopischen und offenen Verfahren. Die fehlende Möglichkeit der Palpation kann bei somatostatinrezeptorexprimierenden Tumoren durch eine präoperative Diagnostik mittels PET-CT und intraoperativer Sonographie kompensiert werden.

Schlussfolgerungen

Die auftretenden Komplikationen bei der Resektion neuroendokriner Tumoren rechtfertigen keine Empfehlung zur offenen oder laparoskopischen Vorgehensweise.

Abstract

Background

Laparoscopic pancreas resections are performed with increasing frequency for pancreatic neuroendocrine tumors and other benign and malignant diseases.

Objectives

This article describes the complications arising from laparoscopic resection of pancreatic neuroendocrine tumors and compares them to complications arising from similar open procedures.

Methods

Case series, reports, trials and meta-analyses were analyzed and the results are described and discussed.

Results

The types and the frequencies of complications are comparable for laparoscopic and open resection of pancreatic neuroendocrine tumors. The lack of the ability to perform an intraoperative examination of the pancreas to detect the tumors can be alleviated by laparoscopic ultrasound examination or in the case of tumors expressing somatostatin receptors by preoperative DOTATATE positron emission tomography (PET) computed tomography (CT) scanning.

Conclusion

The complications arising from the resection of pancreatic neuroendocrine tumors do not justify a recommendation for a laparoscopic or open approach.

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Einhaltung ethischer Richtlinien

Interessenkonflikt. U.A. Wittel und U.T. Hopt geben an, dass kein Interessenkonflikt besteht. Dieser Beitrag beinhaltet keine Studien an Menschen oder Tieren.

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Authors and Affiliations

  1. Department Chirurgie, Klinik für Allgemein- und Visceralchirurgie, Universitätsklinikum Freiburg, Hugstetter Str. 55, 79106, Freiburg, Deutschland

    U.A. Wittel & U.T. Hopt

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  2. U.T. Hopt
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Correspondence to U.A. Wittel.

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Wittel, U., Hopt, U. Komplikationen der minimal-invasiven Pankreasresektion bei neuroendokrinen Pankreastumoren. Chirurg 86, 33–37 (2015). https://doi.org/10.1007/s00104-014-2822-y

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  • DOI: https://doi.org/10.1007/s00104-014-2822-y

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