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Gastroenterologie
a hepatologie

Gastroenterology and Hepatology

Gastroent Hepatol 2018; 72(5): 401–407. doi:10.14735/amgh2018401.

Laparoskopická hemipankreatoduodenektomie u ampulárního adenokarcinomu – kazuistika

Lumír Kunovský1,2, Zdeněk Kala Orcid.org  1, Vladimír Procházka Orcid.org  1, Milan Dastych Orcid.org  3, Ivo Novotný4, Jan Trna Orcid.org  3, Jan Mazanec5, Tomáš Andrašina Orcid.org  6, Michal Eid7, Martin Potrusil8, Petr Moravčík8

+ Pracoviště

Souhrn

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, chirurgie, endoskopie, karcinom pankreatu, laparoskopie, pankreatoduodenektomie, periampulární tumory

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