Der multimorbide Patient – Risikostratifizierung und Indikationsstellung in der Pankreaschirurgie
摘要
Pancreatic surgery is still associated with significant morbidity. In a simultaneously increasingly ageing population with elevated morbidity, the risk stratification and indications for surgery are of particular importance.
ObjectiveAssessment of the impact of multimorbidity of patients on the postoperative outcome after pancreatic surgery.
Material and methodsEvaluation and summary of the available literature.
ResultsThe postoperative morbidity after pancreatic surgery remains high. Relevant comorbidities, such as liver cirrhosis, cardiac and pulmonary diseases and advanced renal insufficiency enormously increase the risk of perioperative morbidity and mortality; however, in high-volume centers with appropriate expertise in pancreatic surgery the mortality is below 5%.
ConclusionPancreatic surgery with severe comorbidity can be safely performed in centers with proven expertise. Nevertheless, a careful interpretation of the indications and good patient selection are essential for the postoperative outcome.