{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,3,9]],"date-time":"2026-03-09T13:38:15Z","timestamp":1773063495791,"version":"3.50.1"},"reference-count":23,"publisher":"Georg Thieme Verlag KG","issue":"03","content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":["Zentralbl Chir"],"published-print":{"date-parts":[[2022,6]]},"abstract":"<jats:title>Zusammenfassung<\/jats:title><jats:p>\n          Einleitung Die pyloruserhaltende partielle Pankreatoduodenektomie stellt eine komplexe viszeralchirurgische Operation dar, insbesondere, wenn simultan eine Resektion und\n\t\t\t\t\tRekonstruktion der portalven\u00f6sen Achse notwendig wird. Eine entscheidende Rolle im Rahmen der Operation spielt die Versorgung des verbleibenden Restpankreas, da die postoperative\n\t\t\t\t\tPankreasfistel (POPF) eine h\u00e4ufige Komplikation mit relevanten Folgen f\u00fcr die betroffenen Patienten darstellt. F\u00fcr die Anastomosierung des Restpankreas stehen verschiedene Techniken zur\n\t\t\t\t\tVerf\u00fcgung: die am h\u00e4ufigsten angewendeten sind die Gang-zu-Mukosa-Pankreatikojejunostomie, die invaginierende Pankreatojejunostomie, die Blumgart-Anastomose sowie die\n\t\t\t\t\tPankreatogastrostomie.<\/jats:p><jats:p>\n          Indikation Histologisch gesichertes Adenokarzinom des Pankreaskopfes.<\/jats:p><jats:p>\n          Prozedur Offene pyloruserhaltende partielle Pankreatoduodenektomie mit segmentaler Pfortaderresektion.<\/jats:p><jats:p>\n          Schlussfolgerung Ein standardisiertes und strukturiertes Vorgehen bei der pyloruserhaltenden partiellen Pankreatoduodenektomie hilft, diesen komplexen Eingriff sicher durchzuf\u00fchren.\n\t\t\t\t\tDie Durchf\u00fchrung einer simultanen Pfortaderresektion erh\u00f6ht zwar die Komplexit\u00e4t des Eingriffes \u2013 nichtsdestotrotz sollte aber bei Verdacht auf Infiltration der portalven\u00f6sen Achse die\n\t\t\t\t\tIndikation zur En-bloc-Resektion gro\u00dfz\u00fcgig gestellt werden, da intraoperativ nicht sicher zwischen einer entz\u00fcndlichen Adh\u00e4renz und einer Tumorinfiltration differenziert werden kann und eine\n\t\t\t\t\tPfortader-\/V.-mesenterica-superior-Resektion die Morbidit\u00e4t und Mortalit\u00e4t des Eingriffes nicht wesentlich erh\u00f6ht. Das Ziel ist immer eine R0-Resektion. Die Wahl der operativen Technik zur\n\t\t\t\t\tVersorgung des Restpankreas sollte vom Operateur anhand von dessen Expertise und ggf. an den vorliegenden Situs adaptiert getroffen werden, da nach aktueller Evidenzlage die wichtigsten\n\t\t\t\t\tAnastomosetechniken hinsichtlich der POPF-Rate gleichwertig erscheinen.<\/jats:p>","DOI":"10.1055\/a-1528-7927","type":"journal-article","created":{"date-parts":[[2021,7,28]],"date-time":"2021-07-28T00:48:37Z","timestamp":1627433317000},"page":"233-241","source":"Crossref","is-referenced-by-count":3,"title":["Pyloruserhaltende partielle Pankreatoduodenektomie mit segmentaler Pfortaderresektion"],"prefix":"10.1055","volume":"147","author":[{"given":"Maximilian","family":"Brunner","sequence":"additional","affiliation":[{"name":"Klinik f\u00fcr Allgemein- und Viszeralchirurgie, Universit\u00e4tsklinikum Erlangen, Deutschland"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Christian","family":"Krautz","sequence":"additional","affiliation":[{"name":"Klinik f\u00fcr Allgemein- und Viszeralchirurgie, Universit\u00e4tsklinikum Erlangen, Deutschland"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Matthias","family":"Maak","sequence":"additional","affiliation":[{"name":"Klinik f\u00fcr Allgemein- und Viszeralchirurgie, Universit\u00e4tsklinikum Erlangen, Deutschland"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Georg F.","family":"Weber","sequence":"additional","affiliation":[{"name":"Klinik f\u00fcr Allgemein- und Viszeralchirurgie, Universit\u00e4tsklinikum Erlangen, Deutschland"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Robert","family":"Gr\u00fctzmann","sequence":"additional","affiliation":[{"name":"Klinik f\u00fcr Allgemein- und Viszeralchirurgie, Universit\u00e4tsklinikum Erlangen, Deutschland"}],"role":[{"role":"author","vocabulary":"crossref"}]}],"member":"194","published-online":{"date-parts":[[2021,7,27]]},"reference":[{"key":"ref2","doi-asserted-by":"publisher","first-page":"4543","DOI":"10.3390\/ijms20184543","article-title":"Current Clinical Strategies of Pancreatic Cancer Treatment and Open Molecular Questions","volume":"20","author":"M Brunner","year":"2019","journal-title":"Int J Mol Sci"},{"key":"ref3","doi-asserted-by":"publisher","first-page":"1011","DOI":"10.1016\/S0140-6736(16)32409-6","article-title":"Comparison of adjuvant gemcitabine and capecitabine with gemcitabine monotherapy in patients with resected pancreatic cancer (ESPAC-4): A multicentre, open-label, randomised, phase 3\n\t\t\t\t\ttrial","volume":"389","author":"J P Neoptolemos","year":"2017","journal-title":"Lancet"},{"key":"ref4","doi-asserted-by":"publisher","first-page":"2395","DOI":"10.1056\/NEJMoa1809775","article-title":"FOLFIRINOX or Gemcitabine as Adjuvant Therapy for Pancreatic Cancer","volume":"379","author":"T Conroy","year":"2018","journal-title":"N Engl J Med"},{"key":"ref6","first-page":"187","article-title":"Gef\u00e4\u00dfrekonstruktion nach Pankreasresektionen: Wann und wie?","volume":"17","author":"D Raptis","year":"2016","journal-title":"Chirurgische Allgemeine"},{"key":"ref7","doi-asserted-by":"publisher","first-page":"354","DOI":"10.1055\/a-1161-9501","article-title":"[Indications for Surgery in Pancreatic Ductal Adenocarcinoma \u2013 Consensus Recommendations by the German Society for General and Visceral Surgery]","volume":"145","author":"O Belyaev","year":"2020","journal-title":"Zentralbl Chir"},{"key":"ref8","doi-asserted-by":"publisher","first-page":"983","DOI":"10.1007\/s11605-020-04591-w","article-title":"National Trends in Robotic Pancreas Surgery","volume":"25","author":"R S Hoehn","year":"2021","journal-title":"J Gastrointest Surg"},{"key":"ref9","doi-asserted-by":"publisher","first-page":"2","DOI":"10.1016\/j.pan.2017.11.011","article-title":"International consensus on definition and criteria of borderline resectable pancreatic ductal adenocarcinoma","volume":"18","author":"S Isaji","year":"2018","journal-title":"Pancreatology"},{"key":"ref10","doi-asserted-by":"publisher","first-page":"14","DOI":"10.1016\/j.pan.2015.10.013","article-title":"International Association of Pancreatology (IAP)\/European Pancreatic Club (EPC) consensus review of guidelines for the treatment of pancreatic cancer","volume":"16","author":"K Takaori","year":"2016","journal-title":"Pancreatology"},{"key":"ref11","doi-asserted-by":"publisher","first-page":"542","DOI":"10.1148\/radiol.2242011283","article-title":"Variant hepatic arterial anatomy revisited: digital subtraction angiography performed in 600 patients","volume":"224","author":"A M Covey","year":"2002","journal-title":"Radiology"},{"key":"ref12","doi-asserted-by":"publisher","first-page":"930","DOI":"10.1097\/SLA.0b013e31818fefc7","article-title":"Pancreatogastrostomy with gastric partition after pylorus-preserving pancreatoduodenectomy versus conventional pancreatojejunostomy: a prospective randomized study","volume":"248","author":"L Fern\u00e1ndez-Cruz","year":"2008","journal-title":"Ann Surg"},{"key":"ref13","doi-asserted-by":"publisher","first-page":"738","DOI":"10.1016\/j.jamcollsurg.2008.12.031","article-title":"Does type of pancreaticojejunostomy after pancreaticoduodenectomy decrease rate of pancreatic fistula? A randomized, prospective, dual-institution trial","volume":"208","author":"A C Berger","year":"2009","journal-title":"J Am Coll Surg"},{"key":"ref14","first-page":"961","article-title":"Duct-to-mucosa anastomosis and incidence of pancreatic fistula following pancreaticoduodenectomy","volume":"22","author":"J M Han","year":"2009","journal-title":"J Med Postgrad"},{"key":"ref15","doi-asserted-by":"publisher","first-page":"745","DOI":"10.1007\/s11605-008-0763-9","article-title":"Reduced postoperative pancreatic fistula rate after pancreatogastrostomy versus pancreaticojejunostomy","volume":"13","author":"U Wellner","year":"2009","journal-title":"J Gastrointest Surg"},{"key":"ref16","doi-asserted-by":"publisher","first-page":"655","DOI":"10.1016\/S1470-2045(13)70126-8","article-title":"Pancreaticojejunostomy versus pancreaticogastrostomy reconstruction after pancreaticoduodenectomy for pancreatic or periampullary tumours: a multicentre randomised trial","volume":"14","author":"B Topal","year":"2013","journal-title":"Lancet Oncol"},{"key":"ref17","doi-asserted-by":"publisher","first-page":"1597","DOI":"10.1002\/bjs.9252","article-title":"Randomized clinical trial of pancreaticogastrostomy versus pancreaticojejunostomy on the rate and severity of pancreatic fistula after pancreaticoduodenectomy","volume":"100","author":"J Figueras","year":"2013","journal-title":"Br J Surg"},{"key":"ref18","doi-asserted-by":"publisher","first-page":"713","DOI":"10.1111\/hpb.12210","article-title":"Isolated Roux loop pancreaticojejunostomy versus pancreaticogastrostomy after pancreaticoduodenectomy: a prospective randomized study","volume":"16","author":"A El Nakeeb","year":"2014","journal-title":"HPB (Oxford)"},{"key":"ref19","doi-asserted-by":"publisher","first-page":"1","DOI":"10.1016\/j.ijsu.2015.02.002","article-title":"Comparative study between duct to mucosa and invagination pancreaticojejunostomy after pancreaticoduodenectomy: a prospective randomized study","volume":"16","author":"A El Nakeeb","year":"2015","journal-title":"Int J Surg"},{"key":"ref20","doi-asserted-by":"publisher","first-page":"154","DOI":"10.1503\/cjs.010014","article-title":"In search of the best reconstructive technique after pancreaticoduodenectomy: pancreaticojejunostomy versus pancreaticogastrostomy","volume":"58","author":"J Grendar","year":"2015","journal-title":"Can J Surg"},{"key":"ref21","doi-asserted-by":"publisher","first-page":"440","DOI":"10.1097\/SLA.0000000000001240","article-title":"Pancreatogastrostomy Versus Pancreatojejunostomy for RECOnstruction After PANCreatoduodenectomy (RECOPANC, DRKS00000767): Perioperative and Long-term Results of a Multicenter Randomized\n\t\t\t\t\tControlled Trial","volume":"263","author":"T Keck","year":"2016","journal-title":"Ann Surg"},{"key":"ref22","doi-asserted-by":"publisher","first-page":"10","DOI":"10.1016\/j.jamcollsurg.2015.10.003","article-title":"Duct-to-Mucosa vs. Invagination for Pancreaticojejunostomy after Pancreaticoduodenectomy: A Prospective, Randomized Controlled Trial from a Single Surgeon","volume":"222","author":"X Bai","year":"2016","journal-title":"J Am Coll Surg"},{"key":"ref23","doi-asserted-by":"publisher","first-page":"389","DOI":"10.1002\/jso.24873","article-title":"Pancreaticojejunostomy: Does the technique matter? A randomized trial","volume":"117","author":"A N Singh","year":"2018","journal-title":"J Surg Oncol"},{"key":"ref24","doi-asserted-by":"publisher","first-page":"48","DOI":"10.1002\/bjs.10727","article-title":"Randomized clinical trial of duct-to-mucosa versus invagination pancreaticojejunostomy after pancreatoduodenectomy","volume":"105","author":"Y Senda","year":"2018","journal-title":"Br J Surg"},{"key":"ref25","doi-asserted-by":"publisher","first-page":"243","DOI":"10.1097\/SLA.0000000000002802","article-title":"Modified Blumgart Mattress Suture Versus Conventional Interrupted Suture in Pancreaticojejunostomy During Pancreaticoduodenectomy: Randomized Controlled Trial","volume":"269","author":"S Hirono","year":"2019","journal-title":"Ann Surg"}],"container-title":["Zentralblatt f\u00fcr Chirurgie - Zeitschrift f\u00fcr Allgemeine, Viszeral-, Thorax- und Gef\u00e4\u00dfchirurgie"],"original-title":[],"language":"de","link":[{"URL":"http:\/\/www.thieme-connect.de\/products\/ejournals\/pdf\/10.1055\/a-1528-7927.pdf","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2023,4,5]],"date-time":"2023-04-05T14:11:55Z","timestamp":1680703915000},"score":1,"resource":{"primary":{"URL":"http:\/\/www.thieme-connect.de\/DOI\/DOI?10.1055\/a-1528-7927"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2021,7,27]]},"references-count":23,"journal-issue":{"issue":"03","published-online":{"date-parts":[[2022,6,15]]},"published-print":{"date-parts":[[2022,6]]}},"URL":"https:\/\/doi.org\/10.1055\/a-1528-7927","archive":["Portico","CLOCKSS"],"relation":{},"ISSN":["0044-409X","1438-9592"],"issn-type":[{"value":"0044-409X","type":"print"},{"value":"1438-9592","type":"electronic"}],"subject":[],"published":{"date-parts":[[2021,7,27]]}}}