Implementation of enhanced recovery programme after pancreatoduodenectomy: A single-centre UK pilot study

被引:64
作者
Abu Hilal, Mohammed [1 ]
Di Fabio, Francesco [1 ]
Badran, AbdAllah [1 ]
Alsaati, Hani [1 ]
Clarke, Hannah [1 ]
Fecher, Imogen [1 ]
Armstrong, Thomas H. [1 ]
Johnson, Colin D. [1 ]
Pearce, Neil W. [1 ]
机构
[1] Univ Hosp Southampton NHS Fdn Trust, Southampton SO16 6YD, Hants, England
关键词
Pancreatoduodenectomy; Enhanced recovery; Fast-track surgery; Outcome; Complications; INTERNATIONAL STUDY-GROUP; FAST-TRACK SURGERY; PANCREATIC SURGERY; ACADEMIC INSTITUTION; CLINICAL PATHWAYS; DEFINITION; MANAGEMENT; IMPACT; COST;
D O I
10.1016/j.pan.2012.11.312
中图分类号
R57 [消化系及腹部疾病];
学科分类号
摘要
Introduction: Data on enhanced recovery programmes after pancreatoduodenectomy (ERP-PD) is limited. The aim of this pilot study was to evaluate the feasibility, safety and clinical outcomes of ERP-PD when implemented at a high-volume UK university referral centre. Methods: This was an observational single-surgeon case-control study (before-and-after pathway). A total of 20 consecutive patients were prospectively enrolled for the ERP-PD and compared with 24 consecutive patients previously treated during an equal time frame. Results: Patients in the ERP-PD group had a significant shorter time to remove naso-gastric tube (median of 5 vs. 7 days, p = 0.0001), start liquid diet (median of 2 vs. 5 days, p < 0.0001), start solid food (median of 4 vs. 9 days, p < 0.0001), pass stools (median of 6 vs. 7 days, p = 0.002), and had shorter length of stay (median of 8.5 days vs. 13 days, p = 0.015) compared to the pre-pathway group. Postoperative complications were overall less frequent but not significantly different in the ERP-PD group (p = 0.077). No difference in mortality and readmission rates was found. Conclusions: Our findings support the feasibility and safety of ERP-PD. Improved patients' outcomes, significant bed day savings and increase National Health Service productivity are anticipated with implementation of ERP-PD on a larger scale. Copyright (C) 2012, IAP and EPC. Published by Elsevier India, a division of Reed Elsevier India Pvt. Ltd. All rights reserved.
引用
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页码:58 / 62
页数:5
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