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Fast-track recovery programme after pancreaticoduodenectomy reduces delayed gastric emptying

Fast-track recovery programme after pancreaticoduodenectomy reduces delayed gastric emptying

Authors :
Alessandro Zerbi
Marco Braga
V. Di Carlo
S. Rocchetti
A. Beneduce
G. Balzano
Balzano, G
Zerbi, A
Braga, Marco
Rocchetti, S
Beneduce, Aa
Di Carlo, V.
Braga, M
Beneduce, A
Di Carlo, V
Publication Year :
2008

Abstract

Background Data on enhanced recovery programmes after pancreatic surgery are sparse. This retrospective cohort study, using historical controls, aimed to evaluate the impact of a fast-track programme after pancreaticoduodenectomy (PD). Methods Between 2004 and 2007, 252 patients undergoing PD were treated by a fast-track programme that included earlier postoperative feeding and mobilization. The patients were compared with an equally sized control group that received a traditional programme from 2000 to 2004. Outcome measures were morbidity, length of stay and readmission rate. Results The rates of pancreatic fistula and other intra-abdominal complications were similar in the two groups. Delayed gastric emptying (DGE) was significantly reduced in the fast-track group (13·9 versus 24·6 per cent; P = 0·004). The independent effect of the fast-track protocol in reducing DGE was confirmed by the multiple regression analysis (adjusted odds ratio 0·477, P = 0·005). Length of stay was reduced with the fast-track protocol (median 13 versus 15 days; P < 0·001), without increasing the readmission rate (7·1 versus 6·3 per cent; P = 0·865). Conclusion A fast-track programme after PD improves gastric emptying and reduces postoperative stay.

Details

Database :
OpenAIRE
Accession number :
edsair.doi.dedup.....ef059740382de4d3c7440ed1c4cd431d