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
Modern perioperative medicine - past, present, and future.
TL;DR: Continuous collection of outcome and process data combined with machine learning, offers a potentially powerful solution to delivering bespoke care pathways and optimising individual management.
Journal ArticleDOI
Overview of Enhanced Recovery After Surgery: The Evolution and Adoption of Enhanced Recovery After Surgery in North America.
TL;DR: When considering the term, Enhanced Recovery is, in its broadest sense, an amalgam of industry, innovation, patient-focused care, cost-effective strategies, and collaboration with a goal of best perioperative outcomes.
Journal ArticleDOI
Extending Enhanced Recovery after Surgery Protocols to the Post-Discharge Setting: A Phone Call Intervention to Support Patients after Expedited Discharge after Pancreaticoduodenectomy.
Rony Takchi,Gregory A. Williams,David G. Brauer,Tina Stoentcheva,Crystal Wolf,Brooke Van Anne,Cheryl A. Woolsey,William G. Hawkins +7 more
TL;DR: In this article, a pilot study was conducted to track patient outcomes after an expedited discharge after enhanced recovery after surgery (ERAS) pathway for pancreaticoduodenectomy (PD).
Journal ArticleDOI
Fast-Track Pancreaticoduodenectomy in the Elderly.
Efstratios Zouros,Theodoros Liakakos,Anastasios Machairas,Paulos Patapis,Helen Tzerbinis,Dimitrios K. Manatakis,Matthaios Papadimitriou-Olivgeris,Christos Dervenis +7 more
TL;DR: An ERAS program seems feasible and can be safely implemented for elderly patients undergoing PD, and there were no differences in compliance with ERAS elements between groups.
Journal ArticleDOI
Clinical implications of bile cultures obtained during pancreatoduodenectomy: a cohort study and meta-analysis.
Jesse V. Groen,Daphne H.M. Droogh,Mark G. J. de Boer,Suzanne Van Asten,Joffrey van Prehn,Akin Inderson,Alexander L. Vahrmeijer,Bert A. Bonsing,J. Sven D. Mieog +8 more
TL;DR: Routine performance of bile cultures should be reconsidered given the rare occurrence of isolated OSIs and similar odds for patients with positive and negative bile culture to develop abdominal infectious complications.
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