Operability boundaries in pancreatic cancer: what is the limit?

Abstract

Preoperative diagnosis of comorbidities is essential for identifying the limiting factors inperioperative period and correct assessment of patient’s ability to undergo surgery. Severe concomitant diseases followed by advanced risk of adverse events require development and implementation of the strategy of preoperative preparation of patient. These measuress hould include both medicamentous and surgical correction of concomitant diseases in order to reduce perioperative risks. Thus, multidisciplinary perioperative approach makes it possible to reduce significantly the risks and mortality in patients undergoing surgery for pancreatic cancer. Diagnosis and correction of limiting factors approach operability to absolute one. However, operation should be avoided or alternative approaches should be preferred if co-morbidities are significant and failed to be corrected.