Guidelines for Perioperative Care for Pancreaticoduodenectomy: Enhanced Recovery After Surgery (ERAS®) Society Recommendations
Kristoffer Lassen,Kristoffer Lassen,Marielle M.E. Coolsen,Karem Slim,Francesco Carli,José Eduardo de Aguilar-Nascimento,Markus Schäfer,Rowan W. Parks,Kenneth C. H. Fearon,Dileep N. Lobo,Nicolas Demartines,Marco Braga,Olle Ljungqvist,Olle Ljungqvist,Cornelis H. C. Dejong +14 more
TLDR
Evidence-based guidelines provide the necessary platform upon which to base a unified protocol for perioperative care for pancreaticoduodenectomy and facilitates multi-institutional prospective cohort registries and adequately powered randomised trials.Abstract:
Protocols for enhanced recovery provide comprehensive and evidence-based guidelines for best perioperative care. Protocol implementation may reduce complication rates and enhance functional recovery and, as a result of this, also reduce length-of-stay in hospital. There is no comprehensive framework available for pancreaticoduodenectomy. An international working group constructed within the Enhanced Recovery After Surgery (ERAS®) Society constructed a comprehensive and evidence-based framework for best perioperative care for pancreaticoduodenectomy patients. Data were retrieved from standard databases and personal archives. Evidence and recommendations were classified according to the GRADE system and reached through consensus in the group. The quality of evidence was rated “high”, “moderate”, “low” or “very low”. Recommendations were graded as “strong” or “weak”. Comprehensive guidelines are presented. Available evidence is summarised and recommendations given for 27 care items. The quality of evidence varies substantially and further research is needed for many issues to improve the strength of evidence and grade of recommendations. The present evidence-based guidelines provide the necessary platform upon which to base a unified protocol for perioperative care for pancreaticoduodenectomy. A unified protocol allows for comparison between centres and across national borders. It facilitates multi-institutional prospective cohort registries and adequately powered randomised trials.read more
Citations
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BookDOI
The SAGES / ERAS® Society Manual of Enhanced Recovery Programs for Gastrointestinal Surgery
TL;DR: The sages eras society manual of enhanced recovery programs for gastrointestinal surgery that you really wait for now is coming and it's significant to wait for the representative and beneficial books to read.
Journal ArticleDOI
Enhanced recovery after surgery (ERAS) protocol reduces LOS without additional adverse events in spine surgery
TL;DR: Findings support the application of the ERAS protocol after spinal surgery, which decreased hospital LOS, without resulting in additional adverse events after spinal operations.
Journal ArticleDOI
Effect of early enteral combined with parenteral nutrition in patients undergoing pancreaticoduodenectomy.
TL;DR: Early enteral combined with parenteral nutrition can greatly improve liver function, reduce infectious complications and delayed gastric emptying, and shorten postoperative hospital stay in patients undergoing pancreaticoduodenectomy.
Journal ArticleDOI
How Sweet Is This? A Review and Evaluation of Preoperative Carbohydrate Loading in the Enhanced Recovery After Surgery Model
Robert S. Ackerman,Robert S. Ackerman,Christopher W. Tufts,David G. DePinto,Jeffrey Chen,Jaclyn R. Altshuler,Andrew A Serdiuk,Jonathan B. Cohen,Sephalie Y. Patel +8 more
TL;DR: Barriers to the adoption of perioperative carbohydrate loading are few, but importantly include overcoming the inertia to modify older and more restrictive fasting guidelines and achieving the multidisciplinary consensus necessary to implement such changes.
Journal ArticleDOI
Clinical Implications of Intraoperative Fluid Therapy in Pancreatic Surgery
Stefano Andrianello,Giovanni Marchegiani,E. Bannone,Gaia Masini,Giuseppe Malleo,Gabriele L Montemezzi,Enrico Polati,Claudio Bassi,Roberto Salvia +8 more
TL;DR: Considering all pancreatic resections, a liberal fluid balance is associated with an increased rate of postoperative morbidity, however, in the case of PD with a soft pancreas, an NZF balance could lead to pancreatic stump ischemia and anastomotic failure.
References
More filters
Journal ArticleDOI
GRADE: an emerging consensus on rating quality of evidence and strength of recommendations
Gordon H. Guyatt,Andrew D Oxman,Gunn Elisabeth Vist,Regina Kunz,Yngve Falck-Ytter,Pablo Alonso-Coello,Holger J. Schünemann +6 more
TL;DR: The advantages of the GRADE system are explored, which is increasingly being adopted by organisations worldwide and which is often praised for its high level of consistency.
Journal ArticleDOI
Intensive Insulin Therapy in Critically Ill Patients
Greet Van den Berghe,Pieter Wouters,Frank Weekers,Charles Verwaest,Frans Bruyninckx,Miet Schetz,Dirk Vlasselaers,Patrick Ferdinande,Peter Lauwers,Roger Bouillon +9 more
TL;DR: Intensive insulin therapy to maintain blood glucose at or below 110 mg per deciliter reduces morbidity and mortality among critically ill patients in the surgical intensive care unit.
Journal ArticleDOI
Audit and feedback: effects on professional practice and healthcare outcomes
Noah Ivers,Gro Jamtvedt,Signe Flottorp,Jane M. Young,Jan Odgaard-Jensen,Simon D. French,Mary Ann O’Brien,Marit Johansen,Jeremy M. Grimshaw,Andrew D Oxman +9 more
TL;DR: The results indicated that feedback may be more effective when baseline performance is low, the source is a supervisor or colleague, it is provided more than once, and the role of context and the targeted clinical behaviour was assessed.
Journal ArticleDOI
What is a randomised controlled trial
Andrea Cipriani,John R. Geddes +1 more
TL;DR: The Consolidated Statement of Reporting Trials (CONSORT) provides readers of RCTs with a list of criteria useful to assess trial validity (for full details visit www.consortstatement.org).
Journal ArticleDOI
Prevention of venous thromboembolism
Willitim Geerts,Joel C. Ray,Clifford W. Colwell,David Bergqvist,Graham F. Pineo,M. R. Lassen,John A. Heit +6 more
TL;DR: The risk factors for VTE among hospitalized patients are outlined, the efficacy and safety of alternative prophylaxis regimens are reviewed, and recommendations regarding the most suitable prophymic regimens based on the estimated risk are provided.