VisualWikitext
(Created blank page)
 
Line 1: Line 1:
{{Infobox surgical procedure
| anesthesia_type = GA +/- epidural
| airway = ETT
| lines_access = 2 PIV + A-line
| monitors = Standard
| considerations_preoperative = Electrolyte disturbances from pancreatitis common, diabetes management
| considerations_intraoperative = Hypovolemia common in pancreatitis, insulin/glucose management
| considerations_postoperative =
}}


A pancreatectomy can be indicated for conditions such as pancreatic stones, cysts, benign or malignant tumors, ductal obstructions, or chronic pancreatitis. It can be classified as '''total''', where the entire organ is removed, often along with the spleen, gallbladder, local lymph nodes, the common bile duct, and portions of the small intestine and stomach, or '''partial''', where the pancreas is resected from the mesenteric vessels distally, leaving the head and uncinate process intact.
== Preoperative management ==
=== Patient evaluation<!-- Describe the unique and important aspects of preoperative evaluation. Add or remove rows from the systems table as needed. --> ===
{| class="wikitable"
|+
!System
!Considerations
|-
|Airway
|
|-
|Neurologic
|
|-
|Cardiovascular
|
|-
|Pulmonary
|
|-
|Gastrointestinal
|
|-
|Hematologic
|
|-
|Renal
|
|-
|Endocrine
|
|-
|Other
|
|}
=== Labs and studies<!-- Describe any important labs or studies. Include reasoning to justify the study and/or interpretation of results in the context of this procedure. If none, this section may be removed. --> ===
* CBC
* Electrolytes, especially K+, serum glucose, BUN, Cr
* Coags including PT, PTT, INR
* LFTs
* urinalysis
* EKG
* CXR
* Echo is commonly requested
=== Operating room setup<!-- Describe any unique aspects of operating room preparation. Avoid excessively granular information. Use drug classes instead of specific drugs when appropriate. If none, this section may be removed. --> ===
* Have insulin available for glucose management
=== Patient preparation and premedication<!-- Describe any unique considerations for patient preparation and premedication. If none, this section may be removed. --> ===
=== Regional and neuraxial techniques<!-- Describe any potential regional and/or neuraxial techniques which may be used for this case. If none, this section may be removed. --> ===
* Epidurals are common to manage postoperative pain
* If epidural is not performed, TAP blocks can be an alternative
== Intraoperative management ==
=== Monitoring and access<!-- List and/or describe monitors and access typically needed for this case. Please describe rationale for any special monitors or access. --> ===
*
=== Induction and airway management<!-- Describe the important considerations and general approach to the induction of anesthesia and how the airway is typically managed for this case. --> ===
=== Positioning<!-- Describe any unique positioning considerations, including potential intraoperative position changes. If none, this section may be removed. --> ===
=== Maintenance and surgical considerations<!-- Describe the important considerations and general approach to the maintenance of anesthesia, including potential complications. Be sure to include any steps to the surgical procedure that have anesthetic implications. --> ===
=== Emergence<!-- List and/or describe any important considerations related to the emergence from anesthesia for this case. --> ===
== Postoperative management ==
=== Disposition<!-- List and/or describe the postoperative disposition and any special considerations for transport of patients for this case. --> ===
=== Pain management<!-- Describe the expected level of postoperative pain and approaches to pain management for this case. --> ===
=== Potential complications<!-- List and/or describe any potential postoperative complications for this case. --> ===
== Procedure variants<!-- This section should only be used for cases with multiple approaches (e.g. Laparoscopic vs. open appendectomy). Otherwise, remove this section. Use this table to very briefly compare and contrast various aspects between approaches. Add or remove rows as needed to maximize relevance. Consider using symbols rather than words when possible (e.g. +, –, additional symbols such as ↑ and ↓ are available using the "Ω" tool in the editor). --> ==
{| class="wikitable wikitable-horizontal-scroll"
|+
!
!Variant 1
!Variant 2
|-
|Unique considerations
|
|
|-
|Position
|
|
|-
|Surgical time
|
|
|-
|EBL
|
|
|-
|Postoperative disposition
|
|
|-
|Pain management
|
|
|-
|Potential complications
|
|
|}
== References ==
[[Category:Surgical procedures]]

Revision as of 09:17, 14 March 2022

Pancreatectomy
Anesthesia type

GA +/- epidural

Airway

ETT

Lines and access

2 PIV + A-line

Monitors

Standard

Primary anesthetic considerations
Preoperative

Electrolyte disturbances from pancreatitis common, diabetes management

Intraoperative

Hypovolemia common in pancreatitis, insulin/glucose management

Postoperative
Article quality
Editor rating
In development
User likes
0

A pancreatectomy can be indicated for conditions such as pancreatic stones, cysts, benign or malignant tumors, ductal obstructions, or chronic pancreatitis. It can be classified as total, where the entire organ is removed, often along with the spleen, gallbladder, local lymph nodes, the common bile duct, and portions of the small intestine and stomach, or partial, where the pancreas is resected from the mesenteric vessels distally, leaving the head and uncinate process intact.

Preoperative management

Patient evaluation

System Considerations
Airway
Neurologic
Cardiovascular
Pulmonary
Gastrointestinal
Hematologic
Renal
Endocrine
Other

Labs and studies

  • CBC
  • Electrolytes, especially K+, serum glucose, BUN, Cr
  • Coags including PT, PTT, INR
  • LFTs
  • urinalysis
  • EKG
  • CXR
  • Echo is commonly requested

Operating room setup

  • Have insulin available for glucose management

Patient preparation and premedication

Regional and neuraxial techniques

  • Epidurals are common to manage postoperative pain
  • If epidural is not performed, TAP blocks can be an alternative

Intraoperative management

Monitoring and access

Induction and airway management

Positioning

Maintenance and surgical considerations

Emergence

Postoperative management

Disposition

Pain management

Potential complications

Procedure variants

Variant 1 Variant 2
Unique considerations
Position
Surgical time
EBL
Postoperative disposition
Pain management
Potential complications

References

Top contributors: Olivia Sutton and Chris Rishel

Retrieved from "https://wikianesthesia.org/w/index.php?title=Pancreatectomy&oldid=4105"