Enhanced recovery pathways in pancreatic surgery: State of the art

Nicolò Pecorelli, Sara Nobile, Stefano Partelli, Luca Cardinali, Stefano Crippa, Gianpaolo Balzano, Luigi Beretta, Massimo Falconi

Research output: Contribution to journalArticle

Abstract

Pancreatic surgery is being offered to an increasing number of patients every year. Although postoperative outcomes have significantly improved in the last decades, even in high-volume centers patients still experience significant postoperative morbidity and full recovery after surgery takes longer than we think. In recent years, enhanced recovery pathways incorporating a large number of evidence-based perioperative interventions have proved to be beneficial in terms of improved postoperative outcomes, and accelerated patient recovery in the context of gastrointestinal, genitourinary and orthopedic surgery. The role of these pathways for pancreatic surgery is still unclear as high-quality randomized controlled trials are lacking. To date, non-randomized studies have shown that care pathways for pancreaticoduodenectomy and distal pancreatectomy are safe with no difference in postoperative morbidity, leading to early discharge and no increase in hospital readmissions. Hospital costs are reduced due to better organization of care and resource utilization. However, further research is needed to clarify the effect of enhanced recovery pathways on patient recovery and post-discharge outcomes following pancreatic resection. Future studies should be prospective and follow recent recommendations for the design and reporting of enhanced recovery pathways.

Original languageEnglish
Pages (from-to)6456-6468
Number of pages13
JournalWorld Journal of Gastroenterology
Volume22
Issue number28
DOIs
Publication statusPublished - Jul 28 2016

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Keywords

  • Evidence-based medicine
  • Length of stay
  • Pancreas surgery
  • Pancreatic neoplasms
  • Perioperative care
  • Postoperative complications

ASJC Scopus subject areas

  • Gastroenterology

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