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Resektion und Transplantation bei Lebertumoren

Liver resection and transplantation for hepatic tumors

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Zusammenfassung

Die Leberchirurgie hat in den letzten beiden Jahrzehnten durch operationstechnische Weiterentwicklungen und Verbesserungen im perioperativen Management wesentliche Fortschritte erzielen können. Dadurch konnte die operationsbedingte Letalität insgesamt deutlich unter 5% gesenkt werden. Dies erlaubt es, immer ausgedehntere Leberresektionen vorzunehmen und die Indikationsstellung auch bei ungünstig lokalisierten Tumoren großzügig zu stellen. Eine weitgehend standardisierte Operationstechnik sowie neue Möglichkeiten der Organkonservierung und insbesondere der Immunsuppression haben dazu geführt, dass bei geeigneter Indikation auch die Lebertransplantation heutzutage als ein Routineverfahren bei der Behandlung von Leberzellkarzinomen angesehen wird. Die vorliegende Arbeit gibt einen Überblick über den gegenwärtigen Stand der chirurgischen Therapie für die häufigsten benignen Leberveränderungen sowie für das hepatozelluläre und cholangiozelluläre Karzinom.

Abstract

Hepatic surgery has made substantial advances in the last two decades due to technical developments and improvements in perioperative management. This has reduced surgery dependent mortality to less than 5%, and provides the possibility of carrying out more substantial hepatic resections and to interpret the indications more liberally, also for tumours localized unfavorably. A widely standardized surgical technique as well as new possibilities for organ conservation and, in particular, immunosuppression mean that given suitable indications, liver transplantation is today regarded as a routine procedure for the treatment of hepatocellular carcinoma. This work provides an overview of the current status of surgical therapy for the most frequent, benign liver tumours, as well as for hepatocellular and cholangiocellular carcinoma.

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  1. Klinik für Allgemein-, Viszeral- und Transplantationschirurgie, Universitätsklinikum Essen, 45122, Hufelandstraße 55, Essen, Deutschland

    H. Lang & C.E. Broelsch

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  1. H. Lang
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Correspondence to H. Lang.

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Lang, H., Broelsch, C. Resektion und Transplantation bei Lebertumoren. Internist 48, 30–39 (2007). https://doi.org/10.1007/s00108-006-1780-y

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