The implementation of an enhanced recovery after surgery (ERAS) program following pancreatic surgery in an academic medical center of China

Pancreatology. 2016 Jul-Aug;16(4):665-70. doi: 10.1016/j.pan.2016.03.018. Epub 2016 Apr 5.

Abstract

Introduction: The experience of implementing enhanced recovery after surgery (ERAS) programs in pancreatic surgery is limited. The aim of this study was to evaluate the feasibility of ERAS program in pancreatic surgery in an academic medical center of China.

Methods: Between May 2014 and August 2015, 124 patients managed with an ERAS program following pancreatic surgery (ERAS group), were compared to a historical cohort of 63 patients, treated with traditional perioperative care between August 2013 and April 2014 (no-ERAS group). Postoperative hospital stay (POPH), unplanned reoperation, unplanned readmissions, mortality and complications were compared between the two groups.

Results: Mean POPH of all patients was significantly reduced (p = 0.007) from 17.1 days (no-ERAS group) to 11.7 days (ERAS group). Especially, mean POPH was reduced significantly in ERAS group of patient with no (7.0 vs. 8.7, p = 0.020) or grade I-II (10.6 vs. 14.4, p = 0.001) complications. There was no difference of complication grades and types between two groups, as well as the rate of mortality, unplanned reoperation and readmission.

Conclusion: The ERAS program is safe and feasible for patients undergoing pancreatic surgery, and it can decrease the postoperative hospital stay.

Keywords: Complication; Enhanced recovery after surgery; Fast track; Pancreatic surgery; Perioperative care; Postoperative hospital stay.

MeSH terms

  • Academic Medical Centers*
  • China
  • Cohort Studies
  • Feasibility Studies
  • Female
  • Hospital Mortality
  • Humans
  • Length of Stay
  • Male
  • Middle Aged
  • Pancreas / surgery*
  • Pancreatic Diseases / pathology
  • Pancreatic Diseases / surgery
  • Pancreaticoduodenectomy / statistics & numerical data
  • Patient Readmission / statistics & numerical data
  • Perioperative Care
  • Postoperative Care / methods*
  • Postoperative Complications / epidemiology
  • Prospective Studies
  • Reoperation / statistics & numerical data
  • Treatment Outcome