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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Early Post-Operative Pancreatitis and Systemic Inflammatory Response Assessed by Serum Lipase and IL-6 Predict Pancreatic Fistula
Silvia Gasteiger,Florian Primavesi,Georg Göbel,E. Braunwarth,Benno Cardini,Manuel Maglione,Sieghart Sopper,Dietmar Öfner,Stefan Stättner +8 more
TL;DR: A combination of serum lipase and IL-6 on POD3 is a highly significant early predictor of CR-POPF and overall complications, potentially guiding patient management.
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Preoperative oral rehydration therapy with 2.5 % carbohydrate beverage alleviates insulin action in volunteers.
Tomoaki Yatabe,Takahiko Tamura,Hiroyuki Kitagawa,Tsutomu Namikawa,Koichi Yamashita,Kazuhiro Hanazaki,Masataka Yokoyama +6 more
TL;DR: The hyperinsulinemic normoglycemic clamp using an artificial pancreas showed that the administration of a 2.5 % carbohydrate oral rehydration solution for preoperative oral reHydration therapy improves insulin action in volunteers.
Journal ArticleDOI
Cachexia, dietetic consultation, and survival in patients with pancreatic and periampullary cancer: A multicenter cohort study.
Anouk E J Latenstein,Willemieke P M Dijksterhuis,Tara M. Mackay,Sandra Beijer,Casper H.J. van Eijck,Ignace H. J. T. de Hingh,I. Quintus Molenaar,Martijn G.H. van Oijen,Hjalmar C. van Santvoort,Marian A. E. de van der Schueren,Judith de Vos-Geelen,Jeanne H.M. de Vries,Johanna W. Wilmink,Marc G. Besselink,Hanneke W. M. van Laarhoven +14 more
TL;DR: Average overall survival did not differ between patients with and without cachexia, but decreased in those with severe weight loss, as compared to those with <10% weight loss during the past half year.
Journal ArticleDOI
Exploration of Fluid Dynamics in Perioperative Patients Using Bioimpedance Analysis
TL;DR: The exploration of fluid dynamics using BIA has shown importance of balanced fluid management during perioperative period and suggests possible causality for the development of ascites or fluid collections during postoperative period in patients undergoing HPB operations.
Journal ArticleDOI
Benefits of post-operative oral protein supplementation in gastrointestinal surgery patients: A systematic review of clinical trials.
TL;DR: There is some evidence to support routinely prescribed oral nutritional supplements that contain protein for gastrointestinal surgery patients in the immediate post-operative stage, but the optimal level of protein supplementation required to maximise recovery in gastrointestinal Surgery patients is effectively unknown.
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