Anesthetic management of a pediatric patient undergoing a pancreatoduodenectomy with portal vein reconstruction.

A pancreatoduodenectomy involves the removal of a tumor from the head of the pancreas. It is a technically difficult procedure requiring experienced anesthesia and surgical teams. The addition of a portal vein reconstruction increases the complexity of the case. A pancreatoduodenectomy is rarely performed on pediatric patients. Although reports of pediatric pancreatoduodenectomies exist in the surgical literature, there are no reports in the anesthesia literature. Anesthesia providers must be prepared to manage these complicated cases because substantial fluid shifts, blood loss, and electrolyte disturbances may occur intraoperatively. We report the perioperative management of a pediatric patient undergoing this procedure.