Perioperative Care Implementation: Evidence-Based Practice for Patients With Pancreaticoduodenectomy Using the Enhanced Recovery After Surgery Guidelines

Cesar Aviles

Marilyn J. Hockenberry

Dionisios Vrochides

David Iannitti

Allyson Cochran

Kendra Tezber

Misty Eller

Janet Desamero

operative surgical procedures, outcome assessment, pancreatic adenocarcinoma
CJON 2017, 21(4), 466-472. DOI: 10.1188/17.CJON.466-472

Background: 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.

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