Hepatic and pancreatic resection surgeries are the standard of care for patients with primary or secondary hepatic and pancreatic tumours. Management of these cancers typically involves aggressive, lengthy procedures with locoregional with or without systemic therapy. Combination of these treatments can lead to a plethora of acute and long-term toxic effects that can, in turn, lead not only to considerable functional morbidity but also to an increased risk of mortality [1,2]. Cancer and its treatments related deconditioning is a serious problem. That is why physical activity recommendations for cancer patients has begun to change. 

      Previous studies have shown that though there is a declining trend of mortality post major abdominal surgeries, the morbidity rates are still high, ranging from Pancreas – Mortality – 1.7%, Major Morbidity – 30%, Liver – Mortality – 3.8%, major Morbidity 19% (Our Hospital data). Studies have been done in the past, highlighting the role of prehabilitation in reducing postoperative complications [3,4]. Nevertheless, the precise protocol of prehabilitation has not been completely established [5,6]. Further work is required to tailor optimal prehabilitation protocols for specific operative procedures.

     Cancer-related fatigue is a well-known side effect of anti-cancer therapies. Exercise interventions have been developed to prevent or counteract fatigue with promising results [7,8]. Thus, we have planned a prehabilitation programme for patients requiring major hepatic (≥3 segment liver resection) and pancreatic resections which includes a structured home-based individualized exercise training.

     Though in our institute currently we are following a prehabilitation programme which also includes a single session of supervised exercise training followed by unsupervised and unmonitored exercise prescription at home. Our hypothesis is that a more structured (more supervised and monitored) individualised exercise prescription-based program may further help in prehabilitation which will improve functional capacity resulting in decrease in the postoperative morbidity and mortality. However, such a program needs to be evaluated for its feasibility and effectiveness in patients undergoing hepatic and pancreatic resection surgeries.