Indian Journal of Cancer
Home  ICS  Feedback Subscribe Top cited articles Login 
Users Online :5410
Small font sizeDefault font sizeIncrease font size
Navigate Here
 »   Next article
 »   Previous article
 »   Table of Contents

Resource Links
 »   Similar in PUBMED
 »  Search Pubmed for
 »  Search in Google Scholar for
 »Related articles
 »   Citation Manager
 »   Access Statistics
 »   Reader Comments
 »   Email Alert *
 »   Add to My List *
 * Requires registration (Free)
 

 Article Access Statistics
    Viewed7260    
    Printed246    
    Emailed9    
    PDF Downloaded825    
    Comments [Add]    
    Cited by others 5    

Recommend this journal

 

 REVIEW ARTICLE
Year : 2011  |  Volume : 48  |  Issue : 1  |  Page : 86-93

Preoperative assessment and optimization in periampullary and pancreatic cancer


1 Department of Anaesthesia, Critical Care and Pain, Tata Memorial Hospital, Mumbai, India
2 Department of Surgery, Flinders Medical Center, Adelaide, Australia
3 Department of Gastrointestinal Surgical Oncology, Tata Memorial Hospital, Mumbai, India

Correspondence Address:
S V Shrikhande
Department of Gastrointestinal Surgical Oncology, Tata Memorial Hospital, Mumbai
India
Login to access the Email id

Source of Support: None, Conflict of Interest: None


DOI: 10.4103/0019-509X.75839

Rights and Permissions

Perioperative management of pancreatic and periampullary cancer poses a considerable challenge to the pancreatic surgeon, anesthesiologist, and the intensive care team. The preoperative surgical evaluation of a pancreatic lesion aims to define the nature of the lesion (malignant or benign), stage the tumor, and to determine resectability or other non-surgical treatment options. Patients are often elderly and may have significant comorbidities and malnutrition. Obstructive jaundice may lead to coagulopathy, infection, renal dysfunction, and adverse outcomes. Routine preoperative biliary drainage can result in higher complication rates, and metal stents may be preferred over plastic stents in selected patients with resectable disease. Judicious use of antibiotics and maintaining fluid volume preoperatively can reduce the incidence of infection and renal dysfunction, respectively. Perioperative fluid therapy with hemodynamic optimization using minimally invasive monitoring may help improve outcomes. Careful patient selection, appropriate preoperative evaluation and optimization can greatly contribute to a favorable outcome after major pancreatic resections.






[FULL TEXT] [PDF]*


        
Print this article     Email this article

  Site Map | What's new | Copyright and Disclaimer
  Online since 1st April '07
  © 2007 - Indian Journal of Cancer | Published by Wolters Kluwer - Medknow