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Role of Preoperative Biliary Stenting and Preoperative Preparation Before Pancreaticoduodenectomy

  • Rishi Batra
  • Chandrakanth Are
Chapter

Abstract

Surgical resection remains the only potentially curative treatment option for patients diagnosed with pancreatic cancer. Pancreaticoduodenectomy is a morbid procedure that is fraught with an acceptable mortality rate, but a high morbidity rate. Preoperative biliary stenting can be used as a bridge to surgery for pancreatic cancer, to minimize the risk of developing cholangitis and to facilitate the administration of neoadjuvant therapy in patients with locally advanced pancreatic cancer. It can also be used for palliation in patients with unresectable disease. However, biliary stenting is not recommended for routine use preoperatively and must be individualized to the patient. Prior to pancreaticoduodenectomy, a thorough, systematic, and methodical approach to risk stratification and preoperative planning is mandatory to improve patient selection and optimize outcomes. A multidisciplinary team approach consisting of surgeons, gastroenterologists, medical oncologists, radiation oncologists, and pain specialists helps to deliver comprehensive care to patients in preparation for the operation.

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© Springer Nature Singapore Pte Ltd. 2018

Authors and Affiliations

  1. 1.Department of SurgeryUniversity of Nebraska Medical CenterOmahaUSA

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