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DOI: 10.1055/s-2007-981242
© Georg Thieme Verlag Stuttgart · New York
Chirurgische Therapie von Lebertumoren
Liver Resection for Hepatic TumorsPublication History
Publication Date:
23 August 2007 (online)
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Zusammenfassung
Die Leberchirurgie hat in den letzten beiden Jahrzehnten wesentlich an Bedeutung zugenommen. Hierzu haben detaillierte Kenntnisse über die funktionelle Anatomie der Leber, Verbesserungen in der bildgebenden Diagnostik und intensivmedizinischen Betreuung nach Leberresektion sowie vor allem operationstechnische Weiterentwicklungen auf dem Gebiet der Leberchirurgie selbst maßgeblich beigetragen. Insgesamt liegt die operationsbedingte Letalität bei Leberresektionen heutzutage deutlich unter 5 %. Dies erlaubt es, die Indikationsstellung auch bei ungünstig lokalisierten Tumoren großzügig zu stellen und immer weiter auszudehnen. Die vorliegende Arbeit gibt einen Überblick über den gegenwärtigen Stand der chirurgischen Resektion für die häufigsten benignen Leberveränderungen, das kavernöse Hämangiom, die fokal noduläre Hyperplasie und das hepatozelluläre Adenom, sowie für das cholangiozelluläre Karzinom und das hepatozelluläre Karzinome in zirrhotischer und nicht-zirrhotischer Leber.
Abstract
In the recent two decades liver surgery has gained tremendous progress due to developments in imaging modalities, perioperative management and surgical technique. Thus, overall mortality after liver resection has been reduced below 5 % allowing a more liberal indication for hepatic resection even in advanced and unfavorably located tumors. This paper gives an overview of the current status of liver resection for the three most frequent benign liver tumors, hemangioma, focal nodular hyperplasia and liver cell adenoma, for intrahepatic cholangiocellular carcinoma as well as for hepatocellular carcinoma with and without underlying cirrhosis including the rare type of fibrolamellar carcinoma.
Schlüsselwörter
benigne Lebertumoren - hepatozelluläres Karzinom - cholangiozelluläres Karzinom - Leberresektion
Key words
benign liver tumors - hepatocellular carcinoma - cholangiocellular carcinoma - liver resection
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Prof. Dr. H. Lang , MA, FACS
Klinik für Allgemein-, Viszeral- und Transplantationschirurgie · Universitätsklinikum Essen
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