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Gallenwege

Was will der Chirurg vom Radiologen wissen?

Biliary system

What does the surgeon want to know from the radiologist?

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Zusammenfassung

Klinisches/methodisches Problem

Eine exakte Diagnostik der Gallenwege ist die Voraussetzung für die chirurgische Therapie von Erkrankungen der Gallenwege.

Radiologische Standardverfahren

Die Magnetresonanz-Cholangiopankreatikographie (MRCP) kann zur Planung chirurgischer Eingriffe, für Staging-Untersuchungen von Malignomen sowie zur Darstellung der vaskulären Anatomie im Oberbauch durch die Computertomographie ergänzt werden.

Methodische Innovationen

Die Aussage der MRCP und Computertomographie (CT) kann für ausgewählte Fragestellungen der Transplantationsmedizin und der Leberchirurgie durch eine digitale Aufarbeitung ergänzt werden. Dadurch kann eine virtuelle Planung von Resektionen mit Volumetrie der einzelnen Lebersegmente erarbeitet werden.

Leistungsfähigkeit

Durch eine MRCP erfolgt die exakte Darstellung der intrahepatisch, extrahepatisch sowie im Pankreaskopf lokalisierten Gallenwege sowie deren Pathologien.

Empfehlung für die Praxis

Die radiologische Diagnostik von Malignomen der Gallenwege, benignen biliären Abflusshindernissen, in der Transplantationsmedizin sowie im postoperativen Komplikationsmanagement ist unabdingbare Voraussetzung einer chirurgischen Therapie.

Abstract

Clinical/methodical issue

Exact diagnostic procedures are prerequisite for surgical treatment of bile duct diseases.

Standard radiological methods

Magnetic resonance cholangiopancreatography may be supplemented by computed tomography (CT) for planning surgical interventions, for staging diagnostics in malignancies and for imaging the vascular anatomy in the upper abdomen.

Methodical innovations

Statements from magnetic resonance cholangiopancreatography (MRCP) and CT may be supplemented via digital workup in selected cases of transplantation medicine and in liver surgery. Thus, a virtual resection planning including volumetry of the individual liver segments can be realized.

Performance

Magnetic resonance cholangiopancreatography provides for exact imaging of intrahepatic and extrahepatic bile ducts as well as those situated within the head of the pancreas and their pathologies.

Practical recommendations

Radiological diagnostics of bile duct malignancies, benign outflow obstructions, in transplantation medicine and in postoperative complication management are an indispensable prerequisite in surgical treatment.

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Authors and Affiliations

  1. Klinik für Allgemein‑, Viszeral- und Gefäßchirurgie, Universitätsklinikum Jena, Erlanger Allee 101, Jena, Deutschland

    A. Bauschke

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A. Bauschke gibt an, dass kein Interessenkonflikt besteht.

Dieser Beitrag beinhaltet keine von den Autoren durchgeführten Studien an Menschen oder Tieren.

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Bauschke, A. Gallenwege. Radiologe 59, 300–305 (2019). https://doi.org/10.1007/s00117-019-0502-0

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