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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Perioperative Fluid Administration in Pancreatic Surgery: a Comparison of Three Regimens
Leonardo Gottin,Alvise Martini,N Menestrina,Vittorio Schweiger,Giuseppe Malleo,Katia Donadello,Enrico Polati +6 more
TL;DR: In patients undergoing pancreatic surgery, a restricted or individually guided GD strategy for management of perioperative fluids can result in fewer complications than a liberal fluid strategy.
Journal ArticleDOI
The clinical indication and feasibility of the enhanced recovery protocol for curative gastric cancer surgery: analysis of 147 consecutive experiences.
Junhyun Lee,Hae-Myung Jeon +1 more
TL;DR: The results of this study suggest that an ERAS protocol is feasible and safely applicable without increasing the morbidity and readmission rate after radical gastrectomy if it is applied to patients with positive and less invasive procedures.
Journal ArticleDOI
Modified ERAS protocol using preoperative oral rehydration therapy: outcomes and issues
Hideki Taniguchi,Hideki Taniguchi,Toshio Sasaki,Hisae Fujita,Hiroko Kobayashi,Rieko Kawasaki,Minako Goloubev,Tomomi Ishikawa,Osami Takano,Takashi Ogata,Haruhiko Cho,Takaki Yoshikawa +11 more
TL;DR: Preoperative fluid management using “preoperative oral rehydration therapy (PO-ORT)” is one of the important features, and it is reported the safety and efficacy of the “modified ERAS® protocol”, including its outcomes and issues.
Journal ArticleDOI
Economic impact of enhanced recovery after surgery protocol in minimally invasive cardiac surgery
Johannes Petersen,Benjamin Kloth,Johanna Konertz,Jens C Kubitz,Leonie Schulte-Uentrop,Gesche Ketels,Hermann Reichenspurner,Evaldas Girdauskas +7 more
TL;DR: In this paper, the authors analyzed the economic impact of a newly established Enhanced Recovery After Surgery (ERAS) protocol in minimally invasive heart valve surgery at a hospital in the Netherlands.
Journal ArticleDOI
The effect of a surgery-specific cardiac output-guided haemodynamic algorithm on outcomes in patients undergoing pancreaticoduodenectomy in a high-volume centre: a retrospective comparative study.
Laurence Weinberg,Jonathan Banting,Leonid Churilov,R L McLeod,K Fernandes,I Chao,T Ho,Damian Ianno,V Liang,Vijayaragavan Muralidharan,Christopher Christophi,Mehrdad Nikfarjam +11 more
TL;DR: In patients undergoing pancreaticoduodenectomy, GDT was associated with restrictive intraoperative fluid intervention, fewer cardiorespiratory complications and a shorter hospital length of stay compared to usual care, which could not exclude an influence of surgical caseload.
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