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Behandlung postoperativer Passagestörungen, Cholangitis und Pankreatitis

Treatment of postoperative impairment of gastrointestinal motility, cholangitis and pancreatitis

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Zusammenfassung

Trotz in den letzten Jahrzehnten deutlich rückläufiger Mortalitätszahlen bleiben große hepatopankreatobiliäre Eingriffe mit einer hohen Morbidität behaftet. Deregulierte Funktionszustände der Darmmotilität sowie Entzündungen und Infektionen im Bereich der operierten Organe haben daran einen beträchtlichen Anteil und tragen zu einer signifikanten Verlängerung der Krankenhausaufenthaltsdauer und zu einer deutlichen Steigerung des Ressourcenverbrauchs bei. Diese Übersichtsarbeit zeigt anhand der Auswertung von aktuellen Grundlagenarbeiten, klinischen Studien, Übersichtsarbeiten, Metaanalysen und Leilinien therapeutische Ansätze und Entwicklungen in der Behandlung der verzögerten Magenentleerung, des prolongierten postoperativen Ileus, der postoperativen Cholangitis und Pankreatitis auf.

Abstract

Although the mortality associated with major hepatopancreaticobiliary surgery has continuously decreased during the last decades, the morbidity of these procedures remains high. Functional disturbances of normal gastrointestinal motility as well as inflammation and infections of surgically treated organs are frequent complications resulting in considerably prolonged lengths of stay in hospital  and increased healthcare costs. This review article highlights the therapeutic approaches and recent developments in the treatment of delayed gastric emptying, prolonged postoperative ileus, postoperative cholangitis and pancreatitis after hepatopancreaticobiliary surgery. Current practice is discussed on the basis of recent results in basic and clinical research, review articles, meta-analyses and guidelines.

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  1. Klinik und Poliklinik für Allgemeine Chirurgie, Viszeral-, Thorax- und Gefäßchirurgie, Universitätsmedizin Greifswald, Ferdinand-Sauerbruch-Straße, 17475, Greifswald, Deutschland

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Schulze, T., Heidecke, CD. Behandlung postoperativer Passagestörungen, Cholangitis und Pankreatitis. Chirurg 86, 540–546 (2015). https://doi.org/10.1007/s00104-015-0004-1

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