Perioperative Care Implementation: Evidence-Based Practice for Patients With Pancreaticoduodenectomy Using the Enhanced Recovery After Surgery Guidelines

Clin J Oncol Nurs. 2017 Aug 1;21(4):466-472. doi: 10.1188/17.CJON.466-472.

Abstract

Background: Pancreatic adenocarcinoma is an aggressive cancer that carries a poor prognosis. Pancreaticoduodenectomy (PD) offers the only potential cure, but the associated morbidity is high. The Enhanced Recovery After Surgery (ERAS) evidence-based guidelines for perioperative care for PD can be used to reduce variations in practice. .

Objectives: The primary aim was to evaluate the feasibility of the ERAS guidelines for patients undergoing PD. Secondary aims were to assess length of stay (LOS), readmission within 30 days, 30-day mortality, and total surgical complication rates. .

Methods: Guideline feasibility was evaluated by percentage completion and compliance to each of the perioperative phases of the guideline. Hospital LOS, 30-day readmission, 30-day mortality, and total surgical complication rates were compared before and after ERAS implementation. .

Findings: The ERAS guidelines were feasible and safely implemented with no change in LOS, readmission, morbidity, and mortality rates.

Keywords: operative surgical procedures; outcome assessment; pancreatic adenocarcinoma.

MeSH terms

  • Evidence-Based Practice*
  • Feasibility Studies
  • Hospital Mortality
  • Humans
  • Length of Stay
  • Pancreaticoduodenectomy / adverse effects
  • Pancreaticoduodenectomy / methods*
  • Patient Readmission
  • Perioperative Care
  • Postoperative Complications
  • Practice Guidelines as Topic*