TY - JOUR
T1 - Pancreaticoduodenectomy after neoadjuvant therapy in a Jehovah's Witness with locally advanced pancreatic cancer
T2 - Case report and approach to avoid transfusion
AU - Magner, David
AU - Ouellette, James R.
AU - Lee, Joseph R.
AU - Colquhoun, Steven
AU - Lo, Simon
AU - Nissen, Nicholas N.
PY - 2006
Y1 - 2006
N2 - Although the morbidity and mortality rates associated with pancreaticoduodenectomy (PD) have been improving over the past several decades, perioperative transfusions are often needed. Here, we review the preoperative planning and overall management of a Jehovah's Witness patient with locally advanced pancreatic cancer who would not accept blood transfusion. Management of this case is reviewed, along with the relevant literature regarding major surgery in the Jehovah's Witness population. The use of neoadjuvant chemoradiation was used successfully in locally advanced disease, allowing surgical resection. In addition, we outline a cogent strategy using pre-, intra-, and postoperative techniques to minimize blood loss and maintain hemoglobin at acceptable levels thereby preventing the need for transfusion. These strategies, once in place, may be able to reduce transfusions in all patients having major resections for malignancy.
AB - Although the morbidity and mortality rates associated with pancreaticoduodenectomy (PD) have been improving over the past several decades, perioperative transfusions are often needed. Here, we review the preoperative planning and overall management of a Jehovah's Witness patient with locally advanced pancreatic cancer who would not accept blood transfusion. Management of this case is reviewed, along with the relevant literature regarding major surgery in the Jehovah's Witness population. The use of neoadjuvant chemoradiation was used successfully in locally advanced disease, allowing surgical resection. In addition, we outline a cogent strategy using pre-, intra-, and postoperative techniques to minimize blood loss and maintain hemoglobin at acceptable levels thereby preventing the need for transfusion. These strategies, once in place, may be able to reduce transfusions in all patients having major resections for malignancy.
UR - http://www.scopus.com/inward/record.url?scp=33745413283&partnerID=8YFLogxK
UR - http://www.scopus.com/inward/citedby.url?scp=33745413283&partnerID=8YFLogxK
M3 - Article
C2 - 16719200
AN - SCOPUS:33745413283
SN - 0003-1348
VL - 72
SP - 435
EP - 437
JO - American Surgeon
JF - American Surgeon
IS - 5
ER -