Séance

50 - Communication libre
Pancreas
3 juin 2021, 13:50 - 15:20, Stream 2: SSCViscérale

Abstract

1
Application of an enhanced recovery pathway for distal pancreatectomy
G. Majid-Jarrar, I. Labgaa, N. Halkic, N. Demartines, M. Hübner, D. Roulin, Presenter: G. Majid-Jarrar (Lausanne)

Objective
Enhanced recovery (ERAS) pathways have shown their safety and efficacy for various major surgeriers including duodeno-pancreatectomy. The present study aimed to analyze compliance with ERAS and postoperative outcomes in distal pancreatectomy.
Methods
Retrospective analysis of consecutive adult patients undergoing elective distal pancreatectomy with or without splenectomy in a tertiary referral center between October 2012 and December 2019.
Results
A total of 83 patients were included (42 males, 41 females) with a mean age of 61.8 ±11.6 years. Spleno-pancreatectomy was performed in 63 (76%) and distal pancreatectomy in 20 (24%) patients. Laparoscopic and open/converted procedures were performed in 42 (51%) and 41 (49%) patients, respectively. Overall complications were reported in 54 (65%) patients, 24 patients (29%) had major complications. There were 18 patients with (22%) pancreatic fistula, 7 (8%) with delayed gastric emptying, and 4 (5%) with post-pancreatectomy hemorrhage. Median length of stay was 10 days (IQR 7-14 days) with 23% readmission rate. Mean overall compliance was 71%, with pre-, intra- and post-operative compliance of 99%, 94% and 48%, respectively. Particularly difficult items were termination of intravenous fluids on postoperative day 2 (22%), and mobilization on day of surgery (21%).
Conclusion
Application of an enhanced recovery pathway for distal pancreatectomy is feasible, showing a high compliance for pre- and intra-operative items. However, application of ERAS items in the post-operative period was more difficult. Further data are necessary to improve distal pancreatectomy-specific enhanced recovery pathway.
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