{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,2,25]],"date-time":"2026-02-25T20:47:58Z","timestamp":1772052478494,"version":"3.50.1"},"reference-count":58,"publisher":"Georg Thieme Verlag KG","issue":"02","content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":["Zentralbl Chir"],"published-print":{"date-parts":[[2022,4]]},"abstract":"<jats:title>Zusammenfassung<\/jats:title><jats:p>Das Ampullenkarzinom stellt eine seltene, jedoch in seiner Inzidenz steigende Entit\u00e4t gastrointestinaler Tumoren dar. Aufgrund der anatomischen Lokalisation f\u00fchrt es vergleichsweise fr\u00fch im\n          Erkrankungsprozess zu einer bili\u00e4ren Gangobstruktion, wodurch eine schnellere Diagnosestellung erleichtert und eine bessere Prognose bedingt werden. Adenome der Ampulla hepatopancreatica und\n          der Papilla duodeni major stellen Vorl\u00e4uferl\u00e4sionen des Ampullenkarzinoms dar und besitzen ein 30\u201340%iges Risiko zur malignen Transformation. Diese Entartungstendenz begr\u00fcndet die\n          Notwendigkeit zur vollst\u00e4ndigen\/kompletten Abtragung im Rahmen der endoskopischen Therapie. Der Erfolg der endoskopischen Papillektomie wird durch eine Ausdehnung des Befundes in den\n          Pankreashauptgang oder Ductus choledochus erschwert. Endoskopisch nicht sanierbare Adenome und Ampullenkarzinome stellen Indikationen f\u00fcr chirurgische Therapieverfahren dar. Grunds\u00e4tzlich\n          sollte f\u00fcr benigne Befunde die transduodenale Papillenresektion bervorzugt werden, f\u00fcr maligne Befunde stellt die Pankreaskopfresektion mit systematischer Lymphadenektomie und\n          Level-II-Dissektion des Mesopankreas die onkologisch korrekte Operation dar. Prognostische Faktoren beim Ampullenkarzinom sind: der pankreatobili\u00e4re Subtyp, eine Lymphknoteninfiltration und\n          eine Perineuralscheideninvasion. Die Differenzierung in histopathologische Subtypen gewinnt zunehmend in der Indikationsstellung zur Systemtherapie an Bedeutung. Der Einsatz der\n          neoadjuvanten und adjuvanten Therapie f\u00fcr das Ampullenkarzinom konnte bisher nicht klar definiert werden. Jedoch scheinen Patienten mit dem pankreatobili\u00e4ren Subtyp oder anderen\n          prognoselimitierenden Faktoren von einer adjuvanten Therapie zu profitieren. Zuk\u00fcnftige Studien werden zur zielgerichteten Therapiefestlegung ben\u00f6tigt.<\/jats:p>","DOI":"10.1055\/a-1775-9024","type":"journal-article","created":{"date-parts":[[2022,4,4]],"date-time":"2022-04-04T22:39:22Z","timestamp":1649111962000},"page":"160-167","source":"Crossref","is-referenced-by-count":2,"title":["Das Ampullenkarzinom \u2013 prognostische und therapeutische Unterschiede zum duktalen Adenokarzinom des Pankreas"],"prefix":"10.1055","volume":"147","author":[{"given":"Esther","family":"Giehl-Brown","sequence":"additional","affiliation":[{"name":"Klinik und Poliklinik f\u00fcr Viszeral-, Thorax- u. Gef\u00e4\u00dfchirurgie, Universit\u00e4tsklinikum Carl Gustav Carus an der Technischen Universit\u00e4t Dresden, Dresden, Deutschland"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"J\u00fcrgen","family":"Weitz","sequence":"additional","affiliation":[{"name":"Klinik und Poliklinik f\u00fcr Viszeral-, Thorax- u. 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