Institute of Surgical Gastroenterology and Liver Transplantation, Government Stanley Medical College, Chennai 600001, India.
Int J Surg. 2014;12(9):1005-9. doi: 10.1016/j.ijsu.2014.07.002. Epub 2014 Jul 9.
Fast track programmes have been introduced in pancreatic surgery, but the data are sparse. The aim of this prospective study was to analyse the feasibility of implementing fast track rehabilitation protocol in PD with pancreaticogastrostomy, using historical control for comparison.
Between April 2012 and December 2012, twenty patients who underwent PD (with pancreaticogastrostomy) were managed by a fast-track rehabilitation protocol. These patients were compared with an equal number of historical controls treated according to the traditional protocol.
Patients in the fast track group were able to tolerate liquid (p = 0.0005) and solid diet (p = 0.0001) earlier, and they passed stools earlier (p = 0.02). Delayed gastric emptying (DGE) was significantly reduced in the fast track group (p = 0.02). There was no difference in the rates of pancreatic fistula (PF), post pancreatectomy haemorrhage (PPH) and mortality between the two groups. Length of hospital stay was reduced in the fast track group (median 14 vs 18.5, p = 0.007).
Fast track programme appears to be feasible in PD, even with pancreatico-gastric anastomosis. It is associated with early recovery, reduced DGE and reduced hospital stay.
快速通道方案已在胰腺外科中实施，但数据有限。本前瞻性研究的目的是分析在胰胃吻合术的 PD 中实施快速康复方案的可行性，并用历史对照进行比较。
在 2012 年 4 月至 12 月期间，20 名接受 PD（胰胃吻合术）的患者接受了快速康复方案的管理。这些患者与根据传统方案治疗的数量相等的历史对照进行了比较。
快速通道组的患者更早地耐受液体（p = 0.0005）和固体饮食（p = 0.0001），并且更早地排便（p = 0.02）。快速通道组的延迟胃排空（DGE）明显减少（p = 0.02）。两组之间的胰瘘（PF）、胰腺切除术后出血（PPH）和死亡率没有差异。快速通道组的住院时间缩短（中位数 14 与 18.5，p = 0.007）。
即使在胰胃吻合术的 PD 中，快速通道方案似乎也是可行的。它与早期恢复、减少 DGE 和减少住院时间有关。
