title: Anaesthetic perioperative management of patients with pancreatic cancer.
abstract: Pancreatic cancer remains a significant and unresolved therapeutic challenge. Currently, the only curative treatment for pancreatic cancer is surgical resection. Pancreatic surgery represents a technically demanding major abdominal procedure that can occasionally lead to a number of pathophysiological alterations resulting in increased morbidity and mortality. Systemic, rather than surgical complications, cause the majority of deaths. Because patients are increasingly referred to surgery with at advanced ages and because pancreatic surgery is extremely complex, anaesthesiologists and surgeons play a crucial role in preoperative evaluations and diagnoses for surgical intervention. The anaesthetist plays a key role in perioperative management and can significantly influence patient outcome. To optimise overall care, patients should be appropriately referred to tertiary centres, where multidisciplinary teams (surgical, medical, radiation oncologists, gastroenterologists, interventional radiologists and anaesthetists) work together and where close cooperation between surgeons and anaesthesiologists promotes the safe performance of major gastrointestinal surgeries with acceptable morbidity and mortality rates. In this review, we sought to provide simple daily recommendations to the clinicians who manage pancreatic surgery patients to make their work easier and suggest a joint approach between surgeons and anaesthesiologists in daily decision making.
authors.affiliation: Lesley De Pietri, Bruno Begliomini, Division of Anaesthesiology and Intensive Care Unit, Azienda Ospedaliero-Universitaria di Modena-Policlinico, 41100 Modena, Italy.
authors.forename: Lesley
authors.initials: L
authors.lastname: De Pietri
authors.affiliation: Lesley De Pietri, Bruno Begliomini, Division of Anaesthesiology and Intensive Care Unit, Azienda Ospedaliero-Universitaria di Modena-Policlinico, 41100 Modena, Italy.
authors.forename: Roberto
authors.initials: R
authors.lastname: Montalti
authors.affiliation: Lesley De Pietri, Bruno Begliomini, Division of Anaesthesiology and Intensive Care Unit, Azienda Ospedaliero-Universitaria di Modena-Policlinico, 41100 Modena, Italy.
authors.forename: Bruno
authors.initials: B
authors.lastname: Begliomini
mesh_terms: D000758:Anesthesia / Q000009:adverse effects / Q000401:mortality; D003299:Cooperative Behavior; D003661:Decision Support Techniques; D006801:Humans; D033183:Interdisciplinary Communication; D010180:Pancreatectomy / Q000009:adverse effects / Q000401:mortality; D010190:Pancreatic Neoplasms / Q000473:pathology / Q000601:surgery*; D010348:Patient Care Team; D018579:Patient Selection; D019990:Perioperative Care; D011183:Postoperative Complications / Q000401:mortality / Q000628:therapy; D011237:Predictive Value of Tests; D018570:Risk Assessment; D012307:Risk Factors; D016896:Treatment Outcome
keywords: Pancreatic cancer; Pancreatic surgery; Perioperative anaesthesia management