Laparoskopická hemipankreatoduodenektomie u ampulárního adenokarcinomu – kazuistika

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Authors: L. Kunovsky ^1,2; Z. Kala ²; V. Procházka ²; M. Dastych ¹; I. Novotný ³; J. Trna ¹; J. Mazanec ⁴; T. Andrasina ⁵; M. Eid ⁶; M. Potrusil ²; P. Moravčík ²
Published in: Gastroent Hepatol 2018; 72(5): 401-407
Category: Gastrointestinal Oncology: Review Article

Overview

Ampulární adenokarcinom (AA) je relativně vzácné onemocnění, tvořící méně něž 1 % všech nádorů gastrointestinálního traktu, ačkoli je to druhá nejčastější malignita periampulární oblasti (po karcinomu pankreatu). Mezi možnosti léčby ampulárních neoplazií patří endoskopická resekce, transduodenální chirurgická ampulektomie nebo hemipankreatoduodenektomie. V době diagnózy onemocnění je u AA vyšší pravděpodobnost kurabilní chirurgické resekce než u karcinomu pankreatu (80 vs. 20 %) a rovněž 5leté přežívání je významně delší. Laparoskopické resekční výkony se staly standardem v kolorektální chirurgii s prokázanými výhodami v časném pooperačním průběhu. V tomto článku prezentujeme kazuistiku 68leté pacientky s AA, u které byla provedena laparoskopická hemipankreatoduodenektomie (LPD). Pojednáváme o výhodách a nevýhodách LPD s hepankreatoduodenektomií prováděnou z otevřeného přístupu, rozebrány jsou léčebné možnosti této diagnózy (vč. endoskopické) a přinášíme přehled součastné literatury.

Klíčová slova:

adenokarcinom Vaterské papily – pankreatoduodenektomie – chirurgie – periampulární tumory – karcinom pankreatu – laparoskopie – endoskopie

Doručeno: 10. 9. 2018

Přijato: 16. 10. 2018

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