A Clinical Observational Study on the Application of Enhanced Recovery After Laparoscopic Pancreaticoduodenectomy

Abstract

Background: The safety and feasibility of enhanced recovery after surgery (ERAS) for laparoscopic pancreaticoduodenectomy (LPD) are unclear. The aim of this retrospective clinical study was to evaluate the impact of ERAS protocols for LPD.Methods: Between March 2016 and December 2018, a total of 34 consecutive patients with ERAS for LPD were prospectively enrolled and compared with 68 consecutive patients previously treated for non-ERAS after LPD during an equal time frame. The intraoperative and postoperative data were collected and comparatively analyzed. Results: The mean length of postoperative hospital stay (15.8±3.4 and 23.1±5.1 days, P<0.001) and total medical costs (¥14.3±4.8 x104 and ¥15.8±4.9 x104, P=0.017) were reduced significantly in ER group than those in non-ER group. The operation time (462.7±117.0 vs 450.9±109.8 min, P=0.627) and intraoperative blood loss (523.5±270.0 vs 537.5±241.8 mL, P=0.800) were similar in the two groups. The complications of patients with ERAS protocols were not increased (P>0.05). No difference in mortality and readmission rates was found.Conclusions: The ERAS is safe and effective in the perioperative period of LPD. It could effectively reduce the length of postoperative stay and medical costs, and does not increase the incidence of postoperative complications.

An assessment of perioperative outcomes for open, laparoscopic, and robot‐assisted pancreaticoduodenectomy

“…For surgery, prolonging the operation time will have a negative impact on the prognosis of patients, such as the incidence of surgical site infection, pulmonary infection, sepsis, and septic shock will increase. 7 PD is the most complicated type of abdominal surgery, and the operation time also increases accordingly, which may be one of the factors that affect the overall incidence of postoperative complications of PD far higher than other abdominal surgery. Some studies have shown that prolonging the operation time will increase the perioperative complications and mortality of PD.…”