[Anesthesiological management of pancreatectomy with curative intention in pancreatic carcinoma]

Pancreatectomy for pancreatic carcinoma makes high demands on the perioperative anesthesiologic management of these patients. This survey is centered on pathophysiological reflections related to the choice of the anesthesia and accompanying therapy, concerning the pathological mechanisms of intra- and postoperative complications. The influences of the surgical as well as the anesthesiological procedure on the autonomous nervous system and splanchnic blood flow, the organo-specific consequences of the resection and the possible influences on the immune system are discussed. Recommendations for perioperative medical care of these patients are derived from it. Central points are an anesthesiologic management adapted to the patient with regard to pathophysiological changes caused by surgery, monitoring and therapy of the disturbed fluid balance, postoperative intensive care as well as an optimal pain treatment.