Fast track--different implications in pancreatic surgery

Area of Science:

• Surgical Oncology
• Gastroenterology
• Perioperative Medicine

Background:

• Fast-track surgery optimizes perioperative care, reducing complications and hospital stay.
• Its application in major pancreatic resections requires further investigation.

Purpose of the Study:

• To evaluate the safety and efficacy of fast-track surgery for major pancreatic resections.
• To assess its impact on patient outcomes, including complication rates and hospital stay.

Main Methods:

• Analysis of perioperative data from 255 consecutive patients undergoing pancreatic resection via fast-track surgery.
• Univariate and multivariate models used to identify factors influencing outcomes.
• Specific pancreatic resection types included pancreatic head, distal, total, and segmental resections.

Main Results:

• Median discharge day was 10, with a 30-day readmission rate of 3.5%.
• In-hospital mortality was 2%, with medical and surgical morbidities at 17% and 25%, respectively.
• Fast-track parameters (e.g., first stools, normal diet, mobilization) correlated with early discharge (p < 0.05).
• Independent factors for early discharge included patient age, operation time, and early extubation (p < 0.05).

Conclusions:

• Fast-track surgery is feasible and safe for major pancreatic resections.
• It facilitates earlier patient discharge without compromising outcomes.
• Low readmission, mortality, and morbidity rates support its widespread adoption.