What are the precautions before pancreatic cancer surgery

Due to the hidden location of the pancreas and the particularity of its structure and function, its early symptoms include upper abdominal discomfort, back pain, jaundice, and diabetes. The 5-year survival rate of patients with early pancreatic cancer after surgery is more than 20%, among which the 5-year survival rate of patients with early pancreatic cancer with negative lymph nodes can reach 40%. Whether surgery is possible is the key to the treatment of pancreatic cancer.

First, we need to determine whether the patient can undergo surgery. For pancreatic ductal adenocarcinoma, pancreatic acinar cell carcinoma, pancreatic adenosquamous carcinoma, pancreatic neuroendocrine carcinoma, and pancreatic metastatic carcinoma (malignant diseases of other organs metastasize to the pancreas), if there are no contraindications to surgery for the above diseases, surgery is actively recommended. After examination, if the patient meets the following criteria, surgical resection is indicated:

1. Severe superior mesenteric vein/portal vein invasion

2. The tumor surrounds the superior mesenteric artery <180 degrees

3. The tumor surrounds the hepatic artery but can be reconstructed

4. Occlusion of a small segment of the superior mesenteric vein can be used for reconstruction and for pancreatic tail tumors that surround the superior mesenteric artery and the celiac trunk <180°.

Tumors with distant metastases, tumors surrounding the superior mesenteric artery >180°, invasion of the abdominal aorta, celiac trunk, or occlusion of the superior mesenteric vein/portal vein and inability to reconstruct were considered unresectable. Tumors with lymph node metastases beyond the range of surgical resection were also considered unresectable.

After confirming that the patient is suitable for surgery, the following preoperative preparations should be made:

1. For patients with weak constitution or a certain age group, timely correction of water and electrolyte imbalance, anemia and hypoproteinemia before surgery should be carried out to enhance the ability to tolerate surgery. It is helpful for patients with infection and trauma to increase nutrition before surgery. For patients with diet and inability to improve, parenteral nutrition conditioning combined with ginsenoside rh2 can be performed to improve the patient's constitution and increase the success rate of surgery.

2. Explain the importance of surgery to the patient and get their full cooperation. For more worried patients, cite cases of recovery after similar surgeries and encourage mutual visits among patients with similar surgeries. At the same time, strengthen communication and contact with family members to support patients in reducing their psychological burden.

3. Understand the patient's previous medical history. For patients with diabetes, regular insulin should be used to control blood sugar within 7.2-8.9 mol/L and urine sugar within the range of (+)-(-) to reduce the possibility of postoperative infection.