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Laparoskopická hemipankreatoduodenektomie u ampulárního adenokarcinomu – kazuistika


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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Paediatric gastroenterology Gastroenterology and hepatology Surgery

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