Границы операбельности при раке поджелудочной железы: что лимитирует?

Предоперационная диагностика сопутствующих заболеваний необходима для выявления лимитирующих факторов в периоперационном периоде и правильной оценки возможностей пациента перенести предстоящее вмешательство. При наличии выраженных сопутствующих и фоновых заболеваний и, как следствие, высокой вероятности развития неблагоприятных событий необходимо разработать стратегию подготовки пациента к оперативному вмешательству и реализовать ее. Такая подготовка должна включать как медикаментозную, так и хирургическую коррекцию сопутствующих заболеваний для уменьшения возможных рисков. Таким образом, взвешенный, командный, мультидисциплинарный подход в периоперационном периоде позволяет значимо уменьшить риски и летальность у пациентов, оперируемых по поводу рака поджелудочной железы. Если мультидисциплинарной команде удается распознать и нейтрализовать лимитирующие факторы, то операбельность приближается к абсолютной, но если улучшения состояния пациента достичь не получается, то от операции следует воздержаться и применить другие методы лечения.

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