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- W2894891408 abstract "Introduction: Enhanced surgical recovery programs are becoming more common due to proven outcome improvements in colorectal surgery. The impact of such programs for pancreaticoduodenectomy is not clear at this point. Our completely integrated enhanced recovery program for major abdominal/pelvic surgery (ASURE) was implemented in January 2016. We hypothesized that implementation of the ASURE program impacted outcomes from pancreatico-duodenectomy. Methods: A retrospective review was performed of all patients undergoing pancreaticoduodenectomy from August 2013 through August 2017. Outcomes were compared for 23 control (prior to January 1, 2016) and 24 ASURE patients. Results: There was no significant difference in age, blood loss, need for vein resection, preoperative chemotherapy, or BMI. There was a statistically significant difference in mean length of stay for the ASURE group (15.1 vs 5.1 days, p < 0.05) with trend to improvement in readmission rate (17.4% vs 12.5%, P = NS). Overall morbidity and mortality were not significantly different (56.5% vs 50.0% and 8.7% vs 8.3%). However, the incidence of Clavien Dindo complications of 3 or greater was significantly lower in the ASURE group (47.8% vs 20.8%, p < 0.05). There were trends towards improvements in delayed gastric emptying (21.7% vs 12.5%), deep space infection (21.7% vs 16.7%) and all grade pancreatic fistula rate (17.4% vs 4.2%) but these did not reach statistical significance. Conclusion: An integrated recovery program appears to have a positive impact on the outcomes from pancreaticoduodenectomy. Continued work is necessary to track this improved outcome in a larger patient population.Tabled 1Results SummaryControl (n=23)ASURE (n=24) *p<0.05Mean Age6056Vein Resection30%29%Preoperative Therapy43.5%58.3%Mean BMI27.929.2Mean Length of Stay (days)15.15.1 *Readmission rate17.4%12.5%3+ Complication Rate47.8%20.8% *Delayed Gastric Emptying21.7%12.5%All Grade Pancreatic Fistula17.4%4.2% Open table in a new tab" @default.
- W2894891408 created "2018-10-12" @default.
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- W2894891408 date "2018-09-01" @default.
- W2894891408 modified "2023-09-27" @default.
- W2894891408 title "The impact of a comprehensive integrative enhanced recovery program on pancreaticoduodenectomy at a single institution" @default.
- W2894891408 doi "https://doi.org/10.1016/j.hpb.2018.06.2123" @default.
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