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Guidelines for perioperative care for pancreaticoduodenectomy: enhanced recovery after surgery (ERAS®) society recommendations
Department of GI and HPB Surgery, University Hospital Northern Norway, Tromsø and Institute of Clinical Medicine, University of Tromsø, Tromsø, Norway; Clinical Surgery, University of Edinburgh, Royal Infirmary of Edinburgh, Edinburgh, United Kingdom.
Department of Surgery, University Hospital Maastricht and NUTRIM School for Nutrition, Toxicology and Metabolism, Maastricht, The Netherlands.
Department of Digestive Surgery, Hospital CHU Estaing, Clermont-Ferrand, France.
Department of Anesthesia, McGill University Health Centre, Montreal QC, Canada.
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2012 (English)In: Clinical Nutrition, ISSN 0261-5614, E-ISSN 1532-1983, Vol. 31, no 6, p. 817-830Article in journal (Refereed) Published
Abstract [en]

Background & Aims: Protocols for enhanced recovery provide comprehensive and evidence-based guidelines for best perioperative care. Protocol implementation may reduce complication rates and enhance functional recovery and, as a result of this, also reduce length-of-stay in hospital. There is no comprehensive framework available for pancreaticoduodenectomy.

Methods: An international working group constructed within the Enhanced Recovery After Surgery (ERAS®) Society constructed a comprehensive and evidence-based framework for best perioperative care for pancreaticoduodenectomy patients. Data were retrieved from standard databases and personal archives. Evidence and recommendations were classified according to the GRADE system and reached through consensus in the group. The quality of evidence was rated "high", "moderate", "low" or "very low". Recommendations were graded as "strong" or "weak".

Results: Comprehensive guidelines are presented. Available evidence is summarised and recommendations given for 27 care items. The quality of evidence varies substantially and further research is needed for many issues to improve the strength of evidence and grade of recommendations.

Conclusions: The present evidence-based guidelines provide the necessary platform upon which to base a unified protocol for perioperative care for pancreaticoduodenectomy. A unified protocol allows for comparison between centres and across national borders. It facilitates multi-institutional prospective cohort registries and adequately powered randomised trials.

Place, publisher, year, edition, pages
Amsterdam, Netherlands: Elsevier, 2012. Vol. 31, no 6, p. 817-830
Keywords [en]
Enhanced Recovery After Surgery (ERAS), pancreatoduodenectomy, whipple, fast track, critical pathway, guidelines, pancreas
National Category
Medical and Health Sciences Nutrition and Dietetics
Research subject
Medicine
Identifiers
URN: urn:nbn:se:oru:diva-27230DOI: 10.1016/j.clnu.2012.08.011ISI: 000313301100003PubMedID: 23079762Scopus ID: 2-s2.0-84870253690OAI: oai:DiVA.org:oru-27230DiVA, id: diva2:602501
Available from: 2013-02-01 Created: 2013-02-01 Last updated: 2018-05-10Bibliographically approved

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