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

Preoperative assessment and optimization in periampullary and pancreatic cancer

S Myatra1, JV Divatia1, B Jibhkate1, GS Barreto2, SV Shrikhande3 
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

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.


How to cite this article:
Myatra S, Divatia J V, Jibhkate B, Barreto G S, Shrikhande S V. Preoperative assessment and optimization in periampullary and pancreatic cancer.Indian J Cancer 2011;48:86-93


How to cite this URL:
Myatra S, Divatia J V, Jibhkate B, Barreto G S, Shrikhande S V. Preoperative assessment and optimization in periampullary and pancreatic cancer. Indian J Cancer [serial online] 2011 [cited 2020 Jul 12 ];48:86-93
Available from: http://www.indianjcancer.com/article.asp?issn=0019-509X;year=2011;volume=48;issue=1;spage=86;epage=93;aulast=Myatra;type=0