Document Detail


Implementation of an enhanced recovery programme following pancreaticoduodenectomy.
MedLine Citation:
PMID:  22954007     Owner:  NLM     Status:  MEDLINE    
Abstract/OtherAbstract:
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.
Authors:
Nichola Robertson; Peter James Gallacher; Natalie Peel; O James Garden; Mark Duxbury; Kristoffer Lassen; Rowan W Parks
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Publication Detail:
Type:  Journal Article    
Journal Detail:
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:
Created Date:  2012-09-07     Completed Date:  2013-01-29     Revised Date:  2014-02-20    
Medline Journal Info:
Nlm Unique ID:  100900921     Medline TA:  HPB (Oxford)     Country:  England    
Other Details:
Languages:  eng     Pagination:  700-8     Citation Subset:  IM    
Copyright Information:
© 2012 International Hepato-Pancreato-Biliary Association.
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MeSH Terms
Descriptor/Qualifier:
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
Grant Support
ID/Acronym/Agency:
CZB/4/693//Chief Scientist Office
Chemical
Reg. No./Substance:
0/Analgesics
Comments/Corrections

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


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