Document Detail


Fast-track programmes for hepatopancreatic resections: where do we stand?
MedLine Citation:
PMID:  22081917     Owner:  NLM     Status:  MEDLINE    
Abstract/OtherAbstract:
BACKGROUND: Fast-track (FT) programmes represent a series of multimodal concepts that may reduce surgical stress and speed up convalescence after surgery. The aim of this systematic review was to evaluate FT programmes for patients undergoing hepatopancreatic surgery.
METHODS: PubMed, Embase and the Cochrane Library databases were searched for studies of FT vs. conventional recovery strategies for liver and pancreatic resections.
RESULTS: For liver surgery, three cohort studies were included. Primary hospital stay was significantly reduced after FT care in two of the three studies. There were no significant differences in rates of readmission, morbidity and mortality. For pancreatic surgery, three cohort studies and one case-control study were included. Primary hospital stay was significantly shorter after FT care in three out of the four studies. One study reported a significantly decreased readmission rate (7% vs. 25%; P= 0.027), and another study showed lower morbidity (47.2% vs. 58.7%; P < 0.01) in favour of the FT group. There was no difference in mortality between the FT and control groups.
CONCLUSIONS: FT rehabilitation for liver and pancreatic surgical patients is feasible. Future investigation should focus on optimizing individual elements of the FT programme within the context of liver and pancreatic surgery.
Authors:
Lidewij Spelt; Daniel Ansari; Christian Sturesson; Bobby Tingstedt; Roland Andersson
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Publication Detail:
Type:  Journal Article; Review     Date:  2011-09-26
Journal Detail:
Title:  HPB : the official journal of the International Hepato Pancreato Biliary Association     Volume:  13     ISSN:  1477-2574     ISO Abbreviation:  HPB (Oxford)     Publication Date:  2011 Dec 
Date Detail:
Created Date:  2011-11-15     Completed Date:  2012-03-12     Revised Date:  2013-06-27    
Medline Journal Info:
Nlm Unique ID:  100900921     Medline TA:  HPB (Oxford)     Country:  England    
Other Details:
Languages:  eng     Pagination:  833-8     Citation Subset:  IM    
Copyright Information:
© 2011 International Hepato-Pancreato-Biliary Association.
Affiliation:
Department of Surgery, Clinical Sciences Lund, Skåne University Hospital Lund and Lund University, Sweden.
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MeSH Terms
Descriptor/Qualifier:
Hepatectomy* / adverse effects,  mortality
Humans
Length of Stay
Liver Diseases / mortality,  surgery*
Pancreatectomy* / adverse effects,  mortality
Pancreatic Diseases / mortality,  surgery*
Patient Discharge
Patient Readmission
Program Development
Program Evaluation
Time Factors
Treatment Outcome
Comments/Corrections

From MEDLINE®/PubMed®, a database of the U.S. National Library of Medicine


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