50 - Communication libre
3 juin 2021, 13:50 - 15:20, Stream 2: SSCViscérale
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)
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.
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.
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%).
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.