Anaesthesia for paediatric HPB surgery

Abstract

Anaesthesia for paediatric hepatico-pancreatico-biliary (HPB) surgery is complex, diverse, and challenging. It is similar to anaesthesia for adult HPB surgery, but the caseload is much smaller and it is difficult to gain significant experience, even in large paediatric centres. Anaesthetists face many challenges in daily practice. There are a variety of patient populations in terms of size, pathophysiology, the presence of syndromes that involve cardiovascular and respiratory pathology, seriously ill children, the need for numerous diagnostic tests in children with HPB pathology, long-lasting vascular access, and postoperative pain control. The role of the anaesthetist involves preassessment, preoperative optimisation, and finally anaesthesia and postoperative analgesia and care. Literature related to this pathology is rare, and the intention of the authors is to summarise the management of anaesthesia for HPB operations that exclude liver transplantation in paediatric populations.