# Surgical and Medical Co‐Management in an 82‐Year‐Old Patient With Hemophilia a Undergoing Pancreaticoduodenectomy

## TL;DR

A multidisciplinary team successfully managed an 82-year-old hemophilia A patient undergoing a complex surgery, avoiding complications and promoting recovery.

## Contribution

The paper introduces a surgical and medical co-management strategy for hemophilia A patients undergoing major surgeries.

## Key findings

- No major complications or perioperative bleeding occurred in the patient.
- The SMC team improved perioperative planning and minimized complications through coordinated care.
- The case demonstrates the effectiveness of shifting from conservative to preventive treatment approaches.

## Abstract

We report the successful application of a surgical and medical co‐management (SMC) strategy in an 82‐year‐old man with hemophilia A (HA) undergoing pancreaticoduodenectomy for pancreatic head carcinoma. No major complications or perioperative bleeding occurred. Optimal management of HA patients undergoing major surgery requires multidisciplinary coordination to avoid postoperative complications. The SMC team integrates internists (who assess chronic disease status, adjust medications, and determine best hemostatic therapies) and surgeons (who evaluate the surgical feasibility of procedures and rely on advanced surgical skills) to improve perioperative planning to minimize complications and promote recovery. This case illustrates the utility of a shift from passive and conservative treatment to active and preventive treatment and highlights the value of SMC in many complex clinical situations.

The surgical and medical co‐management (SMC) team integrates internists and surgeons to improve perioperative planning to minimize complications and promote recovery. SMCs team implemented various perioperative optimization strategies for the patient to prevent complications and enhance satisfaction. This case illustrates the utility of a shift from passive and conservative treatment to active and preventive treatment and highlights the value of SMC in many complex clinical situations.