Improved Outcomes in 394 Pancreatic Cancer Resections: the Impact of Enhanced Recovery Pathway

Journal of Gastrointestinal Surgery : Official Journal of the Society for Surgery of the Alimentary Tract
Vandana AgarwalShailesh V Shrikhande

Abstract

Enhanced recovery (ER) pathway reduces morbidity and accelerates recovery. It is associated with reduced postoperative stay, morbidity, and costs. Feasibility and safety of ER programme has not been studied in developing countries. The objectives were to assess compliance with Enhanced Recovery After Surgery (ERAS) elements and to assess outcomes in pancreatic surgery. Prospective study conducted from February 2014 to December 2016, following elective pancreatic cancer surgery. Team was educated prior to implementation of ERAS. Patients were followed up until 30 days postoperatively or discharge. Data was recorded regarding the compliance with the protocol, functional GI recovery, mobilisation, and postoperative morbidity and mortality. A total of 394 patients underwent surgery. Compliance with ER elements implemented was 84% (23-100%). Compliance > 80% with ER elements was observed in 278 patients (70.5%) and < 80% in 116 patients (29.5%). Patients with > 80% compliance have significantly lower major complications (28.7 vs. 44%, p = 0.001), mortality (2.1 vs. 6.8%, p = 0.021), and postoperative stay (11 (5-78) days vs. 15 (4-61) days, p < 0.001). ER programme is feasible and safe in resource and infrastructure limited lower mi...Continue Reading

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Citations

Oct 13, 2020·HPB : the Official Journal of the International Hepato Pancreato Biliary Association·Amir ParrayShailesh V Shrikhande
May 1, 2021·Journal of Clinical Medicine·Henry John Golder, Vassilios Papalois
May 8, 2021·World Journal of Gastroenterology : WJG·Diamantis I TsilimigrasDimitrios Moris
Jul 1, 2021·HPB : the Official Journal of the International Hepato Pancreato Biliary Association·Riddhi JoshiVandana Agarwal
Jun 23, 2021·HPB : the Official Journal of the International Hepato Pancreato Biliary Association·Dimitrios MorisSabino Zani
Jun 23, 2021·Current Opinion in Clinical Nutrition and Metabolic Care·Lisa MartinOlle Ljungqvist
Oct 31, 2019·Annals of Surgery·Joal D BeaneHenry A Pitt
Sep 11, 2021·Journal of Gastrointestinal Surgery : Official Journal of the Society for Surgery of the Alimentary Tract·J Madison HyerTimothy M Pawlik

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