全球范围内对胰十二指肠切除术快速康复外科的认知。

BACKGROUND: Uptake of ERAS pathways for pancreatic surgery have been slow and impacted by low compliance. OBJECTIVE: To explore global awareness, perceptions and practice of ERAS peri-pancreatoduodenectomy (PD). METHODS: A structured, web-based survey (EPSILON) was administered through the ERAS society and IHPBA membership. RESULTS: The 140 respondents included predominantly males (86.4%), from Europe (45%), practicing surgery (95%) at academic/teaching hospitals (63.6%) over a period of 10-20 years (38.6%). Most respondents identified themselves as general surgeons (68.6%) with 40.7% reporting an annual PD volume of 20-50 cases, practicing post-PD clinical pathways (37.9%), with 31.4% of respondents auditing their outcomes annually. Reduced medical complications, cost and hospital length of stay, and improved patient satisfaction were perceived benefits of compliance to enhancing-recovery. Multidisciplinary co-ordination was considered the most important factor in the implementation and sustainability of peri-PD ERAS pathways, while reluctance to change among health care practitioners, difficulties in data collection and audit, lack of administrative support, and recruitment of an ERAS dedicated nurse were reported to be important barriers. CONCLUSIONS: The EPSILON survey highlighted global clinician perceptions regarding the benefits of compliance to peri-PD ERAS, the importance of individual components, perceived facilitators and barriers, to the implementation and sustainability of these pathways.

背景：加速康复外科（ERAS）在胰腺外科的应用进展缓慢，这主要与低依从性相关。

目的：旨在探索全球范围内对胰腺十二指肠切除术（PD）围手术期加速康复外科的认知、看法和实践情况。

方法：通过 ERAS 协会和国际肝胆胰协会联盟（IHPBA）成员，采用结构化的网络调查（EPSILON）进行研究。

结果：140 名受访者主要为男性（86.4%），来自欧洲（45%），在学术/教学医院（63.6%）工作（95%），工作年限为 10-20 年（38.6%）。大多数受访者自认为是普通外科医生（68.6%），每年进行 20-50 例 PD 手术（40.7%），实施 PD 后临床路径（37.9%），其中 31.4%的受访者每年对其结果进行审核。减少医疗并发症、降低成本和住院时间以及提高患者满意度被认为是遵守加速康复的益处。多学科协调被认为是实施和维持 PD 围手术期 ERAS 路径的最重要因素，而医护人员不愿意改变、数据收集和审核困难、缺乏行政支持以及招募专门的 ERAS 护士被认为是重要的障碍。

结论：EPSILON 调查强调了全球临床医生对遵守 PD 围手术期 ERAS 的益处、对各个组成部分的重要性、对实施和维持这些路径的认知的看法，以及对实施和维持这些路径的认知。