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Pankreasinzidentalome

Bewertung und Therapie

Pancreatic incidentalomas

Correct assessment and therapy

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Zusammenfassung

Aufgrund der Fortschritte in der Schnittbildtechnologie werden Inzidentalome im Pankreas zunehmend häufiger diagnostiziert. Wichtig ist die Unterscheidung nach soliden und zystischen Tumoren. Eine definitive Artdiagnose ist häufig weder bei soliden noch bei zystischen Tumoren präoperativ möglich. Die Operationsindikation richtet sich nach dem Risiko einer malignen Entartung. Dementsprechend ist die Operationsindikation bei soliden Inzidentalomen in Abhängigkeit vom Zustand des Patienten und unabhängig von der Größe des Tumors fast immer gegeben. Bei zystischen Inzidentalomen sollten benigne Veränderungen soweit als möglich ausgeschlossen werden. Ansonsten besteht eine Operationsindikation bei einer Größe von >2 cm. Bei Vorliegen einer intraduktalen papillären muzinösen Neoplasie mit entsprechenden Risikofaktoren wird eine Operationsindikation bei einer Größe von ≥1 cm empfohlen.

Abstract

Due to recent advances in CT/MRI technology, incidentalomas of the pancreas are detected with increasing frequency. Pancreatic incidentalomas should be differentiated into solid and cystic tumors. In both subgroups definitive classification of the tumor is often not possible. Operative therapy is recommended in premalignant or malignant pathologies. Thus solid incidentalomas should be resected independently of their size, if the patient is without serious comorbidities. In case of cystic incidentalomas, benign cystic lesions should be excluded as far as possible. Otherwise they should be resected if their size is ≥2 cm. In case of IPMN with specific risk factors, resection is recommended when the tumor size exceeds 1 cm.

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  1. Abteilung Allgemein- und Viszeralchirurgie, Chirurgische Universitätsklinik, Hugstetter Straße 55, 79106, Freiburg, Deutschland

    U. Hopt & T. Keck

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  1. U. Hopt
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  2. T. Keck
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Correspondence to U. Hopt.

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Hopt, U., Keck, T. Pankreasinzidentalome. Chirurg 78, 713–720 (2007). https://doi.org/10.1007/s00104-007-1373-x

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