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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Journal ArticleDOI
Preparing the Patient for Enhanced Recovery After Surgery.
TL;DR: Current recommendations for preparing patients for surgery within an ERAS® program are described and an ERas® approach for preoperative care is described.
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A systematic review of feeding practices among postoperative patients: is practice in‐line with evidenced‐based guidelines?
TL;DR: The findings demonstrate a gap between postoperative feeding evidence and its practical application and provide a strong rationale for interventions targeting improved nutritional care following surgery.
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Michigan Appropriate Perioperative (MAP) criteria for urinary catheter use in common general and orthopaedic surgeries: results obtained using the RAND/UCLA Appropriateness Method.
Jennifer Meddings,Ted A. Skolarus,Karen E. Fowler,Steven J. Bernstein,Justin B. Dimick,Jason Mann,Sanjay Saint +6 more
TL;DR: The appropriateness of indwelling urinary catheter use during and after common general and orthopaedic surgical procedures is defined to help reduce catheter-associated complications for patients undergoing these procedures.
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Nutritional prehabilitation: physiological basis and clinical evidence.
TL;DR: The physiological basis for nutritional prehabilitation is described and the clinical evidence for its current roles in the perioperative period is evaluated, finding that carbohydrate loading is safe and improves patients’ wellbeing, but does not appear to influence length of hospital stay or rate of postoperative complications.
Journal ArticleDOI
Effects of chewing gum against postoperative ileus after pancreaticoduodenectomy--a randomized controlled trial.
TL;DR: A positive trend was observed of a reduction of the impact of postoperative ileus among patients after pancreatic surgery, and this study contributes valuable methodological experience that is important for future studies of chewing gum interventions during recovery after Pancic surgery.
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