Establish a well-functioning prehabilitation clinic led by properly educated multi-disciplinary teams

The prehab clinic for a structured way of pre-operative assessment and optimisation of the patient in order to reduce perioperative complications.

Morbidity rates after resection of hepatic and pancreatic tumors are high (20-30%). Older patients, especially frail patients, are more prone to complications and require specific preoperative risk stratification in order to supply tailor made prophylactic interventions. The modifiable risk factors: physical performance, frailty, nutritional status, anemia, smoking/alcohol abuse and anxiety will be assessed and optimised in a structured way

All patients expected to be planned for elective resection of a liver or pancreatic resection at the UMCG because of (the suspicion of) a tumor will be referred to a prehab clinic. At the clinic six modifiable pre-operative risk factors will be determined by questionnaires, laboratory values or functional tests. Depending of the scores at these measurements, patients will receive tailor made interventions (prehabilitation) consisting of a physical trainings program, referral to a geriatrician, referral to a dietician, intravenous iron therapy, referral  to a stop smoking program or referral to a psychologist.

Endpoint of this study is to assess the feasibility of a prehabilitation clinic in patients scheduled for elective liver or pancreatic resection, measured by the percentage of patients visiting the prehabilitation clinic and subsequently adheres to the advice and treatments.