Perioperative Care Implementation: Evidence-based practice for patients with pancreaticoduodenectomy using the Enhanced Recovery After Surgery guidelines
Pancreatic adenocarcinoma is an aggressive cancer that carries a poor prognosis. Pancreaticoduodenectomy (PD) offers the only potential cure, but the associated morbidity is high. The Enhanced Recovery After Surgery (ERAS) evidence-based guidelines for perioperative care for PD can be used to reduce variations in practice.OBJECTIVES:
The primary aim was to evaluate the feasibility of the ERAS guidelines for patients undergoing PD. Secondary aims were to assess length of stay (LOS), readmission within 30 days, 30-day mortality, and total surgical complication rates.METHODS:
Guideline feasibility was evaluated by percentage completion and compliance to each of the perioperative phases of the guideline. Hospital LOS, 30-day readmission, 30-day mortality, and total surgical complication rates were compared before and after ERAS implementation.FINDINGS:
The ERAS guidelines were feasible and safely implemented with no change in LOS, readmission, morbidity, and mortality rates.