Wellner Ulrich Friedrich, Bolm Louisa, Vladimirov Miljana, Keck Tobias
Klinik für Chirurgie, Campus Lübeck, Universitätsklinikum Schleswig-Holstein, Ratzeburger Allee 160, 23562, Lübeck, Deutschland.
Klinik für Allgemein‑, Viszeral- und Thoraxchirurgie, Paracelsus Medizinische Privatuniversität Nürnberg, Nürnberg, Deutschland.
Chirurg. 2021 Sep;92(9):771-775. doi: 10.1007/s00104-021-01452-3. Epub 2021 Jul 15.
Approximately 30-40% of pancreatoduodenectomies for adenocarcinomas result in nonpancreatic periampullary adenocarcinoma as the final diagnosis. Depending on the origin, a distinction is made between four different carcinomas with histomorphological subtypes.
Carcinoma location and subtype are of prognostic and therapeutic relevance; however, the preoperative differentiation is often incorrect despite modern diagnostics.
Overview of the current literature on the classification and preoperative diagnostics of periampullary adenocarcinomas.
A precise knowledge of the papillary anatomy is necessary for the correct classification of diagnostic findings. Current studies demonstrate diagnostically valuable information from the anamnesis, imaging and endoscopy.
In ca. 70-80% of cases a correct diagnosis of the type of periampullary adenocarcinoma is possible on the basis of interdisciplinary diagnostics. This potentially enables a correspondingly individualized treatment planning in the preoperative phase.
约30%-40%因腺癌接受胰十二指肠切除术的患者最终诊断为非胰腺壶腹周围腺癌。根据起源不同，可将四种不同的癌及其组织形态学亚型区分开来。
癌的位置和亚型具有预后及治疗意义；然而，尽管有现代诊断方法，术前鉴别诊断仍常出现错误。
对当前有关壶腹周围腺癌分类及术前诊断的文献进行综述。
准确了解乳头解剖结构对于正确分类诊断结果至关重要。当前研究表明，病史、影像学及内镜检查能提供有诊断价值的信息。
约70%-80%的病例可通过多学科诊断正确诊断壶腹周围腺癌的类型。这有可能在术前阶段制定相应的个体化治疗方案。
