Enhanced recovery after surgery protocol enhances early postoperative recovery after pancreaticoduodenectomy

Ramasamy Mahendran; Mallika Tewari; Vinod Kumar Dixit; Hari Shankar Shukla

首页> 中文期刊> 《国际肝胆胰疾病杂志（英文版）》 >Enhanced recovery after surgery protocol enhances early postoperative recovery after pancreaticoduodenectomy

Enhanced recovery after surgery protocol enhances early postoperative recovery after pancreaticoduodenectomy

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Background:Enhanced recovery after surgery (ERAS) protocol is a multimodal,multidisciplinary and evidence-based approach to reduce surgical stress and enhance recovery in the postoperative period.This study aimed to analyze the outcome of ERAS protocol in patients after pancreaticoduodenectomy (PD).Methods:A total of 50 consecutive patients with pancreatic/periampullary cancer who underwent PD between January 2016 to August 2017 were included in the study.As per the institute ERAS protocol,nasogastric tube (NGT) was removed on postoperative day (POD) 1 if output was less than 200mL and oral sips were allowed;oral liquids were allowed on POD2;semisolid diet by POD3;abdominal drain was removed on POD 4 if output was less than 100mL with no evidence of postoperative pancreatic fistula (POPF);normal diet was allowed on POD5.Discharge criteria on POD6 were afebrile,tolerating oral normal diet,pain free and no surgery related complications (defined as per the ISGPS definitions).Results:NGT was removed on POD1 in 45 (90％) patients,abdominal drain removed by POD4 in 41 (82％) and 43 (86％) patients were discharged on POD6.There was no 30-day postoperative mortality.Three (6％) patients had delayed gastric emptying (DGE).None had postoperative hemorrhage and POPF.Readmission rate was 8％.A significant relation was found between the length of hospital stay (LOS) with age (P＜ 0.05)and a marginal relation between LOS and postoperative albumin (P=0.05).Conclusions:ERAS protocol can be safely followed in the perioperative care of patients who undergo PD.Early removal of NGT and allowing oral diet restore bowel function early.ERAS decreases the LOS and postoperative complications.

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《国际肝胆胰疾病杂志（英文版）》 |2019年第2期|188-193|共6页
作者
Ramasamy Mahendran; Mallika Tewari; Vinod Kumar Dixit; Hari Shankar Shukla;
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作者单位

Department of Surgical Oncology;

Institute of Medical Sciences;

Banaras Hindu University;

Varanasi;

UP 221005;

India;

Department of Surgical Oncology;

Institute of Medical Sciences;

Banaras Hindu University;

Varanasi;

UP 221005;

India;

Department of Gastroenterology;

Institute of Medical Sciences;

Banaras Hindu University;

Varanasi;

UP 221005;

India;

Department of Surgical Oncology;

Institute of Medical Sciences;

Banaras Hindu University;

Varanasi;

UP 221005;

India;

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Enhanced recovery after surgery protocol enhances early postoperative recovery after pancreaticoduodenectomy

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