Fast-track recovery after major liver and pancreatic resection from the nursing point of view.

Postoperative fast-track recovery protocols combine various methods to support immediate care of patients who undergo major surgery. These protocols include control of postoperative pain and early beginning of oral diet and mobilization. The combination of these approaches may reduce the rate of postoperative complications and facilitate hospital discharge. The aim of this study was to evaluate progress and parameters of fast-track recovery after major liver and pancreatic resection. A descriptive bibliographical review from 2001 to 2012 via electronic databases such as MEDLINE, PubMed, and Google Scholar was undertaken. Articles that focused on a fast-track protocol were studied. Reports focusing on the implementation of a fast-track protocol in the postoperative recovery of patients after major hepatectomy or pancreatectomy were selected. Fast-track protocols may be applicable to patients recovering after major liver or pancreatic resection. Future research should be focused on particular parameters of the fast-track protocol separately.

Preventing surgically induced diabetes after total pancreatectomy via autologous islet cell reimplantation.

Total pancreatectomy may be the only treatment option that relieves pain and tissue destruction for patients with chronic pancreatitis, but this procedure causes surgically induced diabetes, which is difficult to manage because of the absence of insulin-producing beta cells. Some patients may benefit from autologous islet cell reimplantation, a procedure that involves collecting and purifying the islets of Langerhans from the patient's own resected pancreas and reinfusing them into the patient via the portal vein. Typically, candidates for this procedure are younger adults with nondilated pancreatitis that has yet to develop into glucose intolerance. Islet cell transplantation success varies and is directly related to the quality and quantity of the patient's pancreas and the damage caused by the chronic pancreatitis.

Post-pancreatic resection: general overview and unique complications.

Pancreatic cancer is one of the most silently lethal forms of malignancy. With a lack of evidence-based research regarding pancreatic cancer, the evidence-based treatment options are limited. Currently, the best chance for a curative treatment is a pancreatic resection that typically is combined with chemotherapy and/or radiation therapy. The long-term treatment course and overall survival of the patient depend largely on the pathology report generated from the expurgated tissue analysis. After pancreatic resection, patients may experience both general and unique complications that, if not treated appropriately and assessed correctly, can be lethal. Provided here is a general overview of pancreatic resections and their unique postoperative complications for critical-care nurses. As the first-line provider, critical-care nurses assess and manage acute complications, in addition to educating patients to the long-term complications and how to manage them.

Successful pregnancy following partial pancreatectomy after complications from a laparoscopic adjustable gastric banding.

Each year, increasing numbers of bariatric surgeries are being performed to reduce health risks related to obesity. The improvement in health for these patients has promoted an increase in the possibility of pregnancy for some woman. Because there are lifelong adjustments and the possibility of unique complications from bariatric surgery, pregnancy presents special nursing concerns. Very few cases have been identified in nursing literature discussing pregnancy after complications following a bariatric surgery. This article presents a successful pregnancy after a partial pancreatectomy was performed secondary to acute pancreatitis and ischemic enterocolitis as a complication of laparoscopic gastric banding.

Treatment for pancreatic cancer.

Cancer of the pancreas is the fourth most common malignancy-induced cause of death in the United States. For patients with small primary tumors, surgery may produce long-term survival. However, because most patients are not diagnosed early, chemotherapy or radiation therapy may be beneficial. Combined modality therapies are under investigation and may prolong survival.

Laparoscopic distal pancreatectomy procedures in a rural hospital.

Laparoscopic surgical procedures are replacing traditional, more invasive surgical procedures--even in small, rural hospitals. During a period of 12 months, the authors performed laparoscopic distal pancreatectomy procedures on two patients at a 20-bed hospital in North Dakota. Although surgeons in other countries have reported performing laparoscopic distal pancreatectomy procedures, this is the first published report of a US surgical team performing this procedure. Laparoscopic dissection of the distal pancreas allows preservation of patients' spleens, decreases postoperative pain and length of hospitalization, and permits patients to return to activities of daily living more quickly than with traditional open pancreatectomy procedures.

Needs and care of patients undergoing subtotal pancreatectomy for cancer.

Charts of 45 patients, who underwent subtotal pancreatectomy for cancer, at the University Hospital in Lund, over a 5-year period, were reviewed. The aim was to determine how the patients' symptoms and needs were assessed and cared for as documented by medical and nursing professionals. Data were collected on 107 items of interest for nursing care. The symptoms the patients experienced had consequences on many aspects of their lives. Basic functions, such as eating and elimination, were seriously disturbed before surgery, as well as after the first 3 weeks and 3 months. Pain and changes in sleeping pattern and in mood state were recorded for a majority of the patients. Due to inadequate notes the study cannot reveal the total care given to assist these patients with symptom control. However, certain insufficiencies could be found. The conclusion is that nurses can take a more active part in caring for patients with pancreatic cancer. By using assessment tools, and in cooperation with the surgeons, nurses can assist the patients with nutritional support, pain management, information and emotional support, as well as with physical training, leading to qualitative improvements in the lives of patients with pancreatic cancer.