Guidelines for Perioperative Care for Pancreatoduodenectomy: Enhanced Recovery After Surgery (ERAS) Recommendations 2019.

Details

Serval ID
serval:BIB_229957A2EAA3
Type
Article: article from journal or magazin.
Collection
Publications
Institution
Title
Guidelines for Perioperative Care for Pancreatoduodenectomy: Enhanced Recovery After Surgery (ERAS) Recommendations 2019.
Journal
World journal of surgery
Author(s)
Melloul E., Lassen K., Roulin D., Grass F., Perinel J., Adham M., Wellge E.B., Kunzler F., Besselink M.G., Asbun H., Scott M.J., Dejong CHC, Vrochides D., Aloia T., Izbicki J.R., Demartines N.
ISSN
1432-2323 (Electronic)
ISSN-L
0364-2313
Publication state
Published
Issued date
07/2020
Peer-reviewed
Oui
Volume
44
Number
7
Pages
2056-2084
Language
english
Notes
Publication types: Journal Article ; Review
Publication Status: ppublish
Abstract
Enhanced recovery after surgery (ERAS) pathways are now implemented worldwide with strong evidence that adhesion to such protocol reduces medical complications, costs and hospital stay. This concept has been applied for pancreatic surgery since the first published guidelines in 2012. This study presents the updated ERAS recommendations for pancreatoduodenectomy (PD) based on the best available evidence and on expert consensus.
A systematic literature search was conducted in three databases (Embase, Medline Ovid and Cochrane Library Wiley) for the 27 developed ERAS items. Quality of randomized trials was assessed using the Consolidated Standards of Reporting Trials statement checklist. The level of evidence for each item was determined using the Grading of Recommendations Assessment Development and Evaluation system. The Delphi method was used to validate the final recommendations.
A total of 314 articles were included in the systematic review. Consensus among experts was reached after three rounds. A well-implemented ERAS protocol with good compliance is associated with a reduction in medical complications and length of hospital stay. The highest level of evidence was available for five items: avoiding hypothermia, use of wound catheters as an alternative to epidural analgesia, antimicrobial and thromboprophylaxis protocols and preoperative nutritional interventions for patients with severe weight loss (> 15%).
The current updated ERAS recommendations for PD are based on the best available evidence and processed by the Delphi method. Prospective studies of high quality are encouraged to confirm the benefit of current updated recommendations.
Keywords
Surgery
Pubmed
Web of science
Create date
12/05/2020 16:03
Last modification date
10/07/2020 5:21
Usage data