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Evidence for enhanced recovery in pancreatic cancer surgery
Didier Roulin1, Nicolas Demartines2
1Department of Visceral Surgery, Lausanne University Hospital CHUV and University of Lausanne UNIL, 1011, Lausanne, Switzerland.
Background:
Enhanced recovery is a multimodal and evidence-based perioperative approach with the aim to improve postoperative outcome. Following successful results in colorectal surgery, the implementation of enhanced recovery has spread to many surgical disciplines including pancreatic surgery.
Purpose:
The aim of this study is to review current evidence on enhanced recovery focusing on pancreatic cancer surgery and to discuss potential areas of further development.
Conclusion:
In pancreatic cancer surgery, enhanced recovery is associated with better clinical outcome, especially reduced overall postoperative complications, and reduced length of stay without any increase in readmission rate. The occurrence of delayed gastric emptying, but not pancreatic fistula, seems to be reduced with enhanced recovery. The improved postoperative outcome correlates with net costs savings. The improvement of clinical outcome was mainly described for short-term complications. The extension to long-term outcome and survival benefits, as well as the impact on quality of life, remains to be determined.
