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Pankreatogastrostomie: wann und wie?

Pancreaticogastrostomy: when and how?

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An Erratum to this article was published on 13 March 2017

Zusammenfassung

Hintergrund

Zur Rekonstruktion nach Pankreatoduodenektomie sind prinzipiell zwei grundsätzliche Techniken der Pankreasanastomose etabliert: Pankreatojejunostomie und Pankreatogastrostomie. Die Pankreatogastrostomie ist das neuere und bisher seltener verwendete Verfahren, dessen Entwicklung, Technik und Indikation hier dargestellt werden.

Methodik

Übersicht der Literatur und aktuellen Evidenz.

Ergebnisse

Die aktuellsten randomisiert kontrollierten Studien sowie Metaanalysen zeigen zusammengefasst keine signifikanten Unterschiede hinsichtlich postoperativer Komplikationen und der Pankreasfunktion nach Pankreatogastrostomie vs. Pankreatojejunostomie.

Diskussion

Die Pankreatogastrostomie ist das technisch einfacher zu erlernende Verfahren mit mindestens derselben Sicherheit wie die Pankreatojejunostomie. Im Rahmen minimalinvasiver und parenchymsparender Resektionstechniken ergeben sich neue Anwendungsbereiche für diese Anastomosentechnik.

Abstract

Background

Pancreaticojejunostomy and pancreaticogastrostomy are the two techniques for pancreatic anastomosis that are widely established for the reconstruction after pancreaticoduodenectomy. Pancreaticogastrostomy is the most recent and to date less frequently performed method, the history, techniques and indications of which are presented.

Method

Review of the literature and current evidence.

Results

Current evidence from randomized controlled trials and meta-analyses does not demonstrate significant differences in complication rates or pancreatic function after pancreaticogastrostomy versus pancreaticojejunostomy.

Conclusion

Pancreaticogastrostomy is the technically less demanding procedure, offering at least the same level of safety as pancreaticojejunostomy. Minimally invasive and parenchyma-sparing procedures provide new areas of application for this anastomotic technique.

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Abb. 1

Abbreviations

PD:

Pankreatoduodenektomie

PG:

Pankreatogastrostomie

PJ:

Pankreatojejunostomie

POPF:

postoperative Pankreasfistel

PPH:

postpancreatectomy hemorrhage (Blutung nach Pankreasresektion)

RCT:

randomized controlled trial (randomisierte kontrollierte Studie)

ZPE:

zentrale Pankreatektomie

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Author information

Authors and Affiliations

  1. DHBW Karlsruhe, Karlsruhe, Deutschland

    D. Tittelbach-Helmrich

  2. Klinik für Chirurgie, UKSH Lübeck, Ratzeburger Allee 160, 23538, Lübeck, Deutschland

    T. Keck & U. F. Wellner

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  1. D. Tittelbach-Helmrich
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  2. T. Keck
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  3. U. F. Wellner
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Corresponding author

Correspondence to T. Keck.

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D. Tittelbach-Helmrich, T. Keck und U.F. Wellner geben an, dass kein Interessenkonflikt besteht.

Dieser Beitrag beinhaltet keine von den Autoren durchgeführten Studien an Menschen oder Tieren.

Additional information

U.F. Wellner und D. Tittelbach-Helmrich haben zu gleichen Teilen zur Erstellung des Beitrags beigetragen.

Ein Erratum zu diesem Beitrag ist unter http://dx.doi.org/10.1007/s00104-017-0401-8 zu finden.

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Tittelbach-Helmrich, D., Keck, T. & Wellner, U.F. Pankreatogastrostomie: wann und wie?. Chirurg 88, 11–17 (2017). https://doi.org/10.1007/s00104-016-0319-6

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