Pancreaticoduodenectomy

Pancreaticoduodenectomy

Anesthesia type	General
Airway	ETT
Lines and access	PIV x 2 ART
Monitors	Standard 5-lead EKG ABP +/- CVP
Primary anesthetic considerations
Preoperative	Mechanical bowel prep ERAS
Intraoperative	Combined general + epidural Goal-directed fluid therapy Glucose control Blood transfusion management Lung protective ventilation Avoid hypothermia
Postoperative	PONV ERAS Goal-directed fluid therapy Early NG, foley, and drain removal Early PO nutrition Glycemic control Non-opioid analgesia DVT PPx Pulmonary rehab Early ambulation
Article quality
Editor rating	In development
User likes	1

The Pancreaticoduodenectomy is also known as the Whipple Procedure, after Dr. Allen Whipple. This is the most commonly performed surgery to remove pancreatic tumors, and is typically done for patients who have tumors located in the head of the pancreas or adjacent regions. The procedure is anatomically complicated, and there may be anatomical variations among the various involved blood vessels and ducts in the area. Even after pancreatic resection, the 5-year survival rate is only 15-20% (compared with 5% without surgery).

Preoperative management

Patient evaluation

System	Considerations
Neurologic
Cardiovascular
Pulmonary
Gastrointestinal
Hematologic
Renal
Endocrine
Other

Labs and studies

• CBC, BMP, LFTs, coags
• EKG in any patient with risk factors for CAD

Procedure variants

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