Book chapter
Anesthesia Considerations in Hepatopancreaticobiliary Surgery
Surgery of the Liver, Gallbladder and Pancreas, pp.3-19
Springer Nature Switzerland
2026
DOI: 10.1007/978-3-032-28601-7_1
Abstract
This chapter reviews the perioperative anesthetic management of patients undergoing hepatopancreaticobiliary (HPB) surgery, emphasizing the complexity of care in individuals with underlying liver disease. It outlines comprehensive preoperative assessment strategies, including risk stratification tools such as Child–Turcotte–Pugh, Model for End-stage Liver Disease, and VOCAL-Penn scores. Key pathophysiologic considerations—coagulopathy, ascites, encephalopathy, and multisystem effects of cirrhosis—are discussed in relation to anesthetic planning. Intraoperative management principles are detailed for major HPB procedures, including liver transplantation, hepatectomy, pancreaticoduodenectomy, and cholecystectomy, with a focus on hemodynamic monitoring, goal-directed fluid therapy, coagulation management, and preservation of hepatic perfusion. The chapter also addresses ventilatory strategies, use of transesophageal echocardiography, and evolving roles of adjuncts such as dexmedetomidine and regional anesthesia. Postoperative analgesia and enhanced recovery strategies are highlighted to optimize outcomes and minimize complications.
Details
- Title: Subtitle
- Anesthesia Considerations in Hepatopancreaticobiliary Surgery
- Creators
- Brian Longbottom - University of IowaHarrison Gerdes - University of Iowa
- Contributors
- Hassan Aziz (Editor)
- Resource Type
- Book chapter
- Publication Details
- Surgery of the Liver, Gallbladder and Pancreas, pp.3-19
- DOI
- 10.1007/978-3-032-28601-7_1
- Publisher
- Springer Nature Switzerland; Cham
- Language
- English
- Date published
- 2026
- Academic Unit
- Surgery; Anesthesia
- Record Identifier
- 9985244460902771
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