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Fast track--different implications in pancreatic surgery.

P O Berberat1, H Ingold, A Gulbinas

  • 1Department of General Surgery and Department of Anesthesia, University of Heidelberg, Im Neuenheimer Feld 110, 69120 Heidelberg, Germany.

Journal of Gastrointestinal Surgery : Official Journal of the Society for Surgery of the Alimentary Tract
|April 19, 2007
PubMed
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Fast-track surgery, offering optimal perioperative care, safely improves outcomes for major pancreatic resections. This approach leads to reduced complications and shorter hospital stays for patients.

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.

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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.