Article Outline

Pancreatic Surgery

Preoperative Considerations

Intraoperative Considerations

Postoperative Considerations

Parathyroid Surgery

Preoperative Considerations - Chronic kidney disease, Adenoma versus hyperplasia, Pretreatment with calcitriol (prevent hypocalcemia), Pretreatment with bisphosphonate (prevent “hungry bone syndrome”)

Urolithiasis and Urinary Tract Infections

Postoperative Considerations - Persistent or recurrent hypercalcemia; Management of hypocalcemia: acute and subacute / chronic

Adrenal Surgery

Adrenal-dependent hyperadrenocorticism

Pheochromocytoma

Preoperative Considerations 

Arrhythmias and Hypertension

Risks of Surgery - Hemorrhage; Caval invasion (tumor, thrombi); Thromboembolism

Postoperative Considerations - Thromboembolism; Hypoadrenocorticism
 

Summary

References

KEY POINTS

Diabetic ketoacidosis, hyperglycemic hyperosmolar syndrome, hypoglycemia, insulinoma, hypoadrenocorticism, pheochromocytoma, thyrotoxicosis, and myxedema coma are all examples of life-threatening complications of endocrine disease.

Success in treatment of endocrine emergencies is contingent on early recognition and treatment.

Many endocrine diseases presenting emergently have nonspecific signs and symptoms.  Endocrine crises are often precipitated by concurrent disease, further making early identification difficult.

Article Outline

• Surgical anatomy
• General considerations
• • Signalment and clinical signs
  • Biochemical and hematologic investigations
  • Concurrent diseases
  • Diagnostic imaging
  • • Ultrasound
    • Nuclear scintigraphy
• Surgical diseases of the thyroid glands
• • Hyperthyroidism
  • Thyroid carcinomas
• Surgical diseases of the parathyroid glands
• • Parathyroid neoplasia
• Preoperative stabilization
• • Stabilization and medical management
  • Preparation for surgery
  • Anesthesia
• Surgical techniques
• • Thyroidectomy
  • Parathyroid autotransplantation
  • Parathyroidectomy
• Postoperative care
• Complications
• Prognosis
• References