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DOI: 10.1055/s-2001-14702
Endoskopische Therapie der chronischen Pankreatitis
Endoscopic treatment of chronic pancreatitisPublikationsverlauf
Publikationsdatum:
11. September 2002 (online)

Die chronische Pankreatitis ist ein entzündlicher Krankheitsprozess, in dessen Verlauf es zu irreversiblen strukturellen Veränderungen der Bauchspeicheldrüse kommt. Das Endstadium dieses Prozesses besteht in der Zerstörung der exokrinen und endokrinen Funktion des Organs. Der fibrotische Parenchymumbau führt zu Wandunregelmäßigkeiten und Strikturen des Pankreasgangsystems sowie zur Ausbildung von intraluminalen Proteinpfropfen und Kalkeinlagerungen. Diese Veränderungen entwickeln sich meist vor einer manifesten exokrinen oder endokrinen Störung des Pankreas und erlauben daher eine frühzeitige Diagnosestellung mittels Endosonographie (EUS), endoskopisch retrograder Cholangiopankreatikographie (ERCP) oder Magnetresonanz-Cholangiopankreatikographie (MRCP). Für eine ausführliche Diskussion von Krankheitsätiologie, klinischem Verlauf, diagnostischem Procedere und allgemeinen Behandlungsstrategien sei auf andere Übersichtsarbeiten verwiesen [29] [31]. Der folgende Artikel diskutiert den Stellenwert der endoskopischen Therapie bei chronischer Pankreatitis und stellt die einzelnen Therapieverfahren kurz vor.
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Korrespondenz
Dr. Klaus Mergener
Gastroenterology Section Virginia Mason Medical
Center
P.O. Box 900
1100 Ninth Avenue
Seattle, WA 98111, USA
Telefon: (206) 223-6934