Three decades of change in pancreatoduodenectomy and future prediction of pathological and operative complexity

Halle‐Smith, James; Hodson, James; Coldham, C.; Dasari, Bobby; Chatzizacharias, N.; Marudanayagam, R.; Sutcliffe, Robert P.; Isaac, John; Mirza, Darius F.; Roberts, Keith

doi:10.1093/bjs/znab433

Cited by 2 publications

(1 citation statement)

References 15 publications

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“…The patient's age is one of the first objective data points gathered during the initial consultation. Temporal trends of PD note that the average age of surgical patients has increased and will continue to do so in the coming years [12]. The impact of age on outcomes is complex.…”

Section: Agementioning

confidence: 99%

Current Perioperative Care in Pancreatoduodenectomy: A Step-by-Step Surgical Roadmap from First Visit to Discharge

Giuliani

Perri

Kang

et al. 2023

Cancers

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Pancreaticoduodenectomy (PD) is a mainstay in the management of periampullary tumors. Treatment algorithms increasingly employ a multimodal strategy, which includes neoadjuvant and adjuvant therapies. However, the successful treatment of a patient is contingent on the execution of a complex operation, whereby minimizing postoperative complications and optimizing a fast and complete recovery are crucial to the overall success. In this setting, risk reduction and benchmarking the quality of care are essential frameworks through which modern perioperative PD care must be delivered. The postoperative course is primarily influenced by pancreatic fistulas, but other patient- and hospital-associated factors, such as frailty and the ability to rescue from complications, also affect the outcomes. A comprehensive understanding of the factors influencing surgical outcomes allows the clinician to risk stratify the patient, thereby facilitating a frank discussion of the morbidity and mortality of PD. Further, such an understanding allows the clinician to practice based on the most up-to-date evidence. This review intends to provide clinicians with a roadmap to the perioperative PD pathway. We review key considerations in the pre-, intra-, and post-operative periods.

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Section: Agementioning

confidence: 99%