Laparoscopic Pancreatectomy Periprocedural Care

Updated: Mar 21, 2016
  • Author: Eddy C Hsueh, MD; Chief Editor: Vikram Kate, MBBS, MS, PhD, FACS, FACG, FRCS, FRCS(Edin), FRCS(Glasg), FIMSA, MAMS, MASCRS  more...
  • Print
Periprocedural Care

Equipment

The operative theater should have the standard laparoscopic equipment, video monitors, a selection of straight and angled lenses, standard laparoscopic graspers, dissectors, and scissors. Depending on surgeon preference, laparoscopic staplers, sutures, and energy devices should also be available.

Standard operative equipment for the open procedure should also be readily available.

Next:

Patient Preparation

The patient should be kept on NPO status from midnight the night before surgery. Intravenous access and infusion of fluid should be started preoperatively. A nasogastric tube for gastric decompression and a urinary catheter should be placed before the operation is begun. Standard patient padding and deep vein thrombosis (DVT) prophylaxis should be observed. Consideration of invasive monitoring, including an arterial line and central venous access, is tailored to the patient’s conditions.

Laparoscopic pancreatectomy should be performed with the patient under general endotracheal anesthesia. The patient should be in supine or lithotomy position, depending on the type of resection planned and on the individual surgeon's preference.

Previous
Next:

Monitoring and Follow-up

In the postoperative period, a complete blood count and metabolic panel, including amylase, lipase, and a liver function panel, should be performed daily. Critically ill patients may require more frequent laboratory checks, as well as arterial blood gas monitoring.

The outpatient follow-up is dictated by the disease process being treated.

Previous