Department of General Surgery, Peking Union Medical College Hospital, Chinese Academy of Medical Sciences and Peking Union Medical College, Beijing, 100730, China.
Department of Anesthesiology, Peking Union Medical College Hospital, Chinese Academy of Medical Sciences and Peking Union Medical College, Beijing, 100730, China.
Int J Surg. 2018 Feb;50:79-86. doi: 10.1016/j.ijsu.2017.10.067. Epub 2017 Oct 26.
Pancreaticoduodenectomy (PD) remains a morbid procedure. The use of Enhanced Recovery After Surgery (ERAS) pathways has proven to reduce care time and post-operative complications after colorectal surgery. There is a high potential for reducing morbidity associated with PD by utilizing ERAS. Guidelines for perioperative care after PD were published in 2013, but these recommendations could even change in one year. The purpose of this review is to examine the current evidence for ERAS in preoperative, intraoperative and post-operative setting of care for PD patients and to propose ERAS evidence-based protocol for patients undergoing PD. Evidence indicates that ERAS protocols may be implemented in PD without compromising patient safety or increasing length of stay. ERAS in the context of PD should be standardized based on the best available evidence, and ERAS programmes involving multiple centers should be performed.
胰十二指肠切除术（PD）仍然是一种高风险的手术。加速康复外科（ERAS）方案的应用已被证明可以减少结直肠手术后的住院时间和术后并发症。通过使用 ERAS 可以降低与 PD 相关的发病率。2013 年发布了 PD 围手术期护理指南，但这些建议甚至可能在一年内发生变化。本综述的目的是检查 PD 患者术前、术中及术后 ERAS 的现有证据，并为接受 PD 的患者提出基于 ERAS 的协议。有证据表明，在不影响患者安全或增加住院时间的情况下，可以在 PD 中实施 ERAS 方案。在 PD 的背景下，ERAS 应该基于最佳可用证据进行标准化，并且应该进行多中心参与的 ERAS 项目。
