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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 Kunovský, Zdeněk Kala, Vladimír Procházka, Milan Dastych, Ivo Novotný, Jan Trna, Jan Mazanec, Tomáš Andrašina, Michal Eid, Martin Potrusil, Petr Moravčík

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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