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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Current status of the “enhanced recovery after surgery” program in gastric cancer surgery
Yukinori Yamagata,Takaki Yoshikawa,Masahiro Yura,Sho Otsuki,Shinji Morita,Hitoshi Katai,Toshiro Nishida +6 more
TL;DR: Every study showed that the ERAS protocol reduced the cost and duration of hospital stay without increasing surgical complication rates, suggesting that ERAS is effective for gastric cancer surgery.
Journal ArticleDOI
Preoperative Biliary Stenting and Major Morbidity After Pancreatoduodenectomy: Does Elapsed Time Matter?: The FRAGERITA Study Group.
Marta Sandini,Kim C. Honselmann,David Jérémie Birnbaum,Francesca Gavazzi,Mircea Chirica,Ulrich F. Wellner,Théophile Guilbaud,Louisa Bolm,Marco Angrisani,Vincent Moutardier,Marco Cereda,Edouard Girard,Marco Montorsi,Tobias Keck,Alessandro Zerbi,Luca Gianotti +15 more
TL;DR: In this article, the authors investigated the association between the duration of preoperative biliary stent placement and postoperative morbidity and found that delaying surgery up to 1 month after stent insertion may reduce major morbidity, procedure-related complications and length of hospital stay.
Journal ArticleDOI
Future Perspectives of ERAS: A Narrative Review on the New Applications of an Established Approach
Dario Bugada,Valentina Bellini,Andrea Fanelli,Maurizio Marchesini,Christian Compagnone,Marco Baciarello,Massimo Allegri,Guido Fanelli +7 more
TL;DR: Different items within ERAS protocols should be reinterpreted and eventually integrated towards “protective” techniques, to develop cancer-specific ERAS approaches keeping pace with the specific aims of oncologic surgery.
Journal ArticleDOI
Health economics evidence for medical nutrition: are these interventions value for money in integrated care?
TL;DR: Based on the systematic literature search that was performed, it was shown that medical nutrition interventions offer value for money in the different health care settings, particularly for the specific disease areas that have been pointed out.
Journal ArticleDOI
Understanding Enhanced Recovery After Surgery Guidelines: An Introductory Approach
TL;DR: The general principles of the ERAS guidelines are summarized and workload is distributed among the different members of the care team, providing an easier way to involve key personnel in theERAS process and assigns a role for everyone in making ERAS a success.
References
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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.