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Laterale Anastomosentechniken

Partington-Rochelle und „V-Shape-Exzision“

Lateral anastomosis techniques

Partington-Rochelle and V-shaped excision

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Zusammenfassung

Konservativ schwer einstellbare Schmerzen sowie endokrine und exokrine Insuffizienz sind die charakteristischen Symptome der chronischen Pankreatitis. Die chirurgisch einfachen Drainage- und die erweiterten resezierenden Drainageverfahren richten sich hauptsächlich auf die Schmerzreduktion und die Behebung der Organkomplikationen der chronischen Pankreatitis. Unter der Annahme, dass die Pankreasgangveränderungen mit konsekutiver intraduktaler Druckerhöhung die Schmerzursache ist, wurden die Drainageoperationen erfolgreich zur Dekompression des Pankreasgangsystems mit einer Schmerzreduktion bei bis zu 80% der Patienten und niedrigen Morbiditäts- und Mortalitätsraten durchgeführt. Bei eingetretenen Organkomplikationen, wie der entzündliche Pankreaskopftumor und Stenosen des distalen Gallenganges, werden die erweiterten Drainageverfahren mit zusätzlicher limitierter Pankreaskopfresektion nach Frey oder die V-förmige Exzision des ventralen Pankreas mit limitierter Pankreaskopfresektion eingesetzt.

Abstract

Characteristic symptoms of chronic pancreatitis are difficult to manage conservatively. They include severe pain and endocrine and exocrine insufficiency. Surgical treatment with simple and extended draining procedures addresses pain relief and the management of chronic pancreatitis-associated complications of adjacent organs. Following the assumption that pancreatic duct changes with intraductal hypertension are the reason for pain, simple drainage procedures have reduced pain in up to 80% of patients, with low morbidity and mortality. In case of complications involving adjacent organs with inflammatory pancreatic head tumor and stenosis of the distal bile duct, extended drainage procedures with limited pancreatic head resection according to Frey and V-shaped excision of the ventral aspect of the pancreas have been performed successfully.

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Authors and Affiliations

  1. Klinik und Poliklinik für Allgemein-, Viszeral- und Thoraxchirurgie, Universitätsklinikum Hamburg-Eppendorf, Hamburg-Eppendorf, Deutschland

    C.G. Schneider, G. Cataldegirmen, O. Mann, E.F. Yekebas & J.R. Izbicki

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  1. C.G. Schneider
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  2. G. Cataldegirmen
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  3. O. Mann
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  4. E.F. Yekebas
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  5. J.R. Izbicki
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Correspondence to C.G. Schneider.

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Schneider, C., Cataldegirmen, G., Mann, O. et al. Laterale Anastomosentechniken. Chirurg 80, 28–33 (2009). https://doi.org/10.1007/s00104-008-1578-7

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