| Implementation of an enhanced recovery programme following pancreaticoduodenectomy. | |
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MedLine Citation:
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PMID: 22954007 Owner: NLM Status: MEDLINE |
Abstract/OtherAbstract:
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OBJECTIVES: The aim of this prospective study was to investigate the implementation of an enhanced recovery after surgery (ERAS) programme following pancreaticoduodenectomy (PD). METHODS: Patients undergoing PD were managed according to an ERAS protocol. Outcome measures included postoperative mortality, morbidity, hospitalization and 30-day readmission rate. Key protocol targets were: nasogastric tube (NGT) removal [postoperative day (PoD) 1]; resumption of oral fluids (PoD 1); urinary catheter removal (PoD 3); high-dependency unit (HDU) discharge (PoD 3); tolerating diet (PoD 4); drain removal (PoD 5), and hospital discharge (PoD 6). RESULTS: Data were collected for 50 patients (24 male; median age 67 years). Rates of mortality, morbidity and readmission were 4%, 46% and 4%, respectively. The median length of postoperative hospitalization was 10 days. The proportions of patients achieving key targets were: 78% for NGT removal; 82% for resumption of oral fluids; 48% for urinary catheter removal; 82% for HDU discharge; 86% for tolerating diet; 84% for meeting mobility targets, and 72% for drain removal. One patient was discharged by PoD 6, eight patients by PoD 7, 15 patients by PoD 8 and 26 patients (52%) by PoD 10. Discharge was delayed in 16 patients for social or transport-related reasons. CONCLUSIONS: The ERAS protocol was implemented safely. Achieving certain targets was challenging. Non-medical causes remain a significant factor in delayed discharge following PD. |
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Authors:
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Nichola Robertson; Peter James Gallacher; Natalie Peel; O James Garden; Mark Duxbury; Kristoffer Lassen; Rowan W Parks |
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Publication Detail:
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Type: Journal Article |
Journal Detail:
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Title: HPB : the official journal of the International Hepato Pancreato Biliary Association Volume: 14 ISSN: 1477-2574 ISO Abbreviation: HPB (Oxford) Publication Date: 2012 Oct |
Date Detail:
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Created Date: 2012-09-07 Completed Date: 2013-01-29 Revised Date: 2013-04-16 |
Medline Journal Info:
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Nlm Unique ID: 100900921 Medline TA: HPB (Oxford) Country: England |
Other Details:
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Languages: eng Pagination: 700-8 Citation Subset: IM |
Copyright Information:
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© 2012 International Hepato-Pancreato-Biliary Association. |
Affiliation:
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Department of Clinical Surgery, University of Edinburgh, Royal Infirmary of Edinburgh, Edinburgh, UK. |
Export Citation:
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APA/MLA Format Download EndNote Download BibTex |
| MeSH Terms | |
Descriptor/Qualifier:
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Aged Analgesics / therapeutic use Device Removal Diet Drainage / instrumentation Female Hospital Mortality Humans Intubation, Gastrointestinal / instrumentation Length of Stay Male Pain Measurement Pain, Postoperative / diagnosis, drug therapy, etiology Pancreaticoduodenectomy* / adverse effects, mortality Patient Discharge Patient Readmission Pilot Projects Program Evaluation Prospective Studies Recovery of Function Severity of Illness Index Time Factors Treatment Outcome Urinary Catheterization / instrumentation Urinary Catheters |
| Chemical | |
Reg. No./Substance:
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0/Analgesics |
From MEDLINE®/PubMed®, a database of the U.S. National Library of Medicine
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