Summary
Despite some technical problems related to anatomy, proximal bile duct carcinoma can frequently be resected with intention for cure as R0 resection. In certain cases liver transplantation may be a further option. After resection (frequently advanced tumor stages), a 5-year survival rate of 25% can be realized. In most cases preoperative diagnostic workup will not be able to differentiate between resectability and irresectability; therefore, most frequently exploratory laparotomy will be indicated. It may be not justified to presume irresectability in the case of suspected Klatskin tumor and to perform drainage procedure solely with the intention for palliation.
Zusammenfassung
Trotz anatomisch ungünstiger Lokalisation kann ein proximales Gallengangskarzinom relativ häufig mit kurativer Intention im Sinne einer RO-Resektion behandelt werden. Auch eine Lebertransplantation erscheint in Einzelfallen angebracht. 5-Jahresüberlebensraten nach Resektion (häufig Spätstadien) können mit etwa 25% erreicht werden. Eine präoperative Diagnostik erlaubt häufig nicht die Unterscheidung zwischen Resektabilität und Irresektabilität; eine Laparotomie ist deshalb häufig angezeigt. Für nicht berechtigt wird gehalten, daß häufig bei der Verdachtsdiagnose Klatskin-Tumor von vornherein Irresektabilität angenommen und lediglich palliativ drainiert wird.
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© 1994 Springer-Verlag Berlin Heidelberg
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Pichlmayr, R., Weimann, A. (1994). Proximales Gallengangskarzinom (radikale Resektionsintention und Lebertransplantation). In: Hartel, W. (eds) Die Ambivalenz des Fortschritts — ist weniger mehr?. Deutsche Gesellschaft für Chirurgie, vol 1994. Springer, Berlin, Heidelberg. https://doi.org/10.1007/978-3-642-79242-7_26
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DOI: https://doi.org/10.1007/978-3-642-79242-7_26
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