Enhanced recovery after surgery protocol enhances early postoperative recovery after pancreaticoduodenectomy
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摘要
Background: Enhanced recovery after surgery(ERAS) protocol is a multimodal, multidisciplinary and evidence-based approach to reduce surgical stress and enhance recovery in the postoperative period. This study aimed to analyze the outcome of ERAS protocol in patients after pancreaticoduodenectomy(PD). Methods: A total of 50 consecutive patients with pancreatic/periampullary cancer who underwent PD between January 2016 to August 2017 were included in the study. As per the institute ERAS protocol, nasogastric tube(NGT) was removed on postoperative day(POD) 1 if output was less than 200 mL and oral sips were allowed; oral liquids were allowed on POD2; semisolid diet by POD3; abdominal drain was removed on POD 4 if output was less than 100 mL with no evidence of postoperative pancreatic fistula(POPF); normal diet was allowed on POD5. Discharge criteria on POD6 were afebrile, tolerating oral normal diet, pain free and no surgery related complications(defined as per the ISGPS definitions). Results: NGT was removed on POD1 in 45(90%) patients, abdominal drain removed by POD4 in 41(82%) and 43(86%) patients were discharged on POD6. There was no 30-day postoperative mortality. Three(6%) patients had delayed gastric emptying(DGE). None had postoperative hemorrhage and POPF. Readmission rate was 8%. A significant relation was found between the length of hospital stay(LOS) with age( P < 0.05) and a marginal relation between LOS and postoperative albumin( P = 0.05). Conclusions: ERAS protocol can be safely followed in the perioperative care of patients who undergo PD. Early removal of NGT and allowing oral diet restore bowel function early. ERAS decreases the LOS and postoperative complications.
Background: Enhanced recovery after surgery(ERAS) protocol is a multimodal, multidisciplinary and evidence-based approach to reduce surgical stress and enhance recovery in the postoperative period. This study aimed to analyze the outcome of ERAS protocol in patients after pancreaticoduodenectomy(PD). Methods: A total of 50 consecutive patients with pancreatic/periampullary cancer who underwent PD between January 2016 to August 2017 were included in the study. As per the institute ERAS protocol, nasogastric tube(NGT) was removed on postoperative day(POD) 1 if output was less than 200 mL and oral sips were allowed; oral liquids were allowed on POD2; semisolid diet by POD3; abdominal drain was removed on POD 4 if output was less than 100 mL with no evidence of postoperative pancreatic fistula(POPF); normal diet was allowed on POD5. Discharge criteria on POD6 were afebrile, tolerating oral normal diet, pain free and no surgery related complications(defined as per the ISGPS definitions). Results: NGT was removed on POD1 in 45(90%) patients, abdominal drain removed by POD4 in 41(82%) and 43(86%) patients were discharged on POD6. There was no 30-day postoperative mortality. Three(6%) patients had delayed gastric emptying(DGE). None had postoperative hemorrhage and POPF. Readmission rate was 8%. A significant relation was found between the length of hospital stay(LOS) with age( P < 0.05) and a marginal relation between LOS and postoperative albumin( P = 0.05). Conclusions: ERAS protocol can be safely followed in the perioperative care of patients who undergo PD. Early removal of NGT and allowing oral diet restore bowel function early. ERAS decreases the LOS and postoperative complications.
Background: Enhanced recovery after surgery(ERAS) protocol is a multimodal, multidisciplinary and evidence-based approach to reduce surgical stress and enhance recovery in the postoperative period. This study aimed to analyze the outcome of ERAS protocol in patients after pancreaticoduodenectomy(PD). Methods: A total of 50 consecutive patients with pancreatic/periampullary cancer who underwent PD between January 2016 to August 2017 were included in the study. As per the institute ERAS protocol, nasogastric tube(NGT) was removed on postoperative day(POD) 1 if output was less than 200 mL and oral sips were allowed; oral liquids were allowed on POD2; semisolid diet by POD3; abdominal drain was removed on POD 4 if output was less than 100 mL with no evidence of postoperative pancreatic fistula(POPF); normal diet was allowed on POD5. Discharge criteria on POD6 were afebrile, tolerating oral normal diet, pain free and no surgery related complications(defined as per the ISGPS definitions). Results: NGT was removed on POD1 in 45(90%) patients, abdominal drain removed by POD4 in 41(82%) and 43(86%) patients were discharged on POD6. There was no 30-day postoperative mortality. Three(6%) patients had delayed gastric emptying(DGE). None had postoperative hemorrhage and POPF. Readmission rate was 8%. A significant relation was found between the length of hospital stay(LOS) with age( P < 0.05) and a marginal relation between LOS and postoperative albumin( P = 0.05). Conclusions: ERAS protocol can be safely followed in the perioperative care of patients who undergo PD. Early removal of NGT and allowing oral diet restore bowel function early. ERAS decreases the LOS and postoperative complications.
引文
[1]Kehlet H.Multimodal approach to control postoperative pathophysiology and rehabilitation.Br J Anaesth 1997;78:606-617.
[2]Kehlet H,Dahl JB.Anaesthesia,surgery,and challenges in postoperative recovery.Lancet 2003;362:1921-1928.
[3]Gottschalk A,Sharma S,Ford J,Durieux ME,Tiouririne M.Review article:the role of the perioperative period in recurrence after cancer surgery.Anesth Analg 2010;110:1636-1643.
[4]Zhuang CL,Huang DD,Chen FF,Zhou CJ,Zheng BS,Chen BC,et al.Laparoscopic versus open colorectal surgery within enhanced recovery after surgery programs:a systematic review and meta-analysis of randomized controlled trials.Surg Endosc 2015;29:2091-2100.
[5]Wan KM,Carter J,Philp S.Predictors of early discharge after open gynecological surgery in the setting of an enhanced recovery after surgery protocol.JObstet Gynaecol Res 2016;42:1369-1374.
[6]Azhar RA,Bochner B,Catto J,Goh AC,Kelly J,Patel HD,et al.Enhanced Recovery after urological surgery:a contemporary systematic review of outcomes,key elements,and research needs.Eur Urol 2016;70:176-187.
[7]Thorell A,MacCormick AD,Awad S,Reynolds N,Roulin D,Demartines N,et al.Guidelines for perioperative care in bariatric surgery:Enhanced Recovery After Surgery(ERAS)Society recommendations.World J Surg2016;40:2065-2083.
[8]Melloul E,Hübner M,Scott M,Snowden C,Prentis J,Dejong CH,et al.Guidelines for perioperative care for liver surgery:Enhanced Recovery After Surgery(ERAS)Society recommendations.World J Surg 2016;40:2425-2440.
[9]Jeong O,Ryu SY,Park YK.Postoperative functional recovery after gastrectomy in patients undergoing enhanced recovery after surgery:a prospective assessment using standard discharge criteria.Medicine(Baltimore)2016;95:e3140.
[10]Xiong J,Szatmary P,Huang W,de la Iglesia-Garcia D,Nunes QM,Xia Q,et al.Enhanced recovery after surgery program in patients undergoing pancreaticoduodenectomy:a PRISMA-compliant systematic review and meta-analysis.Medicine(Baltimore)2016;95:e3497.
[11]Kagedan DJ,Ahmed M,Devitt KS,Wei AC.Enhanced recovery after pancreatic surgery:a systematic review of the evidence.HPB(Oxford)2015;17:11-16.
[12]Coolsen MM,van Dam RM,van der Wilt AA,Slim K,Lassen K,Dejong CH.Systematic review and meta-analysis of enhanced recovery after pancreatic surgery with particular emphasis on pancreaticoduodenectomies.World J Surg2013;37:1909-1918.
[13]Kawai M,Yamaue H.Analysis of clinical trials evaluating complications after pancreaticoduodenectomy:a new era of pancreatic surgery.Surg Today2010;40:1011-1017.
[14]Winter JM,Cameron JL,Campbell KA,Arnold MA,Chang DC,Coleman J,et al.1423 pancreaticoduodenectomies for pancreatic cancer:a single-institution experience.J Gastrointest Surg 2006;10:1199-1211.
[15]Raimondi S,Maisonneuve P,Lowenfels AB.Epidemiology of pancreatic cancer:an overview.Nat Rev Gastroenterol Hepatol 2009;6:699-708.
[16]Enestvedt CK,Diggs BS,Cassera MA,Hammill C,Hansen PD,Wolf RF.Complications nearly double the cost of care after pancreaticoduodenectomy.Am JSurg 2012;204:332-338.
[17]Barreto SG,Singh A,Perwaiz A,Singh T,Adlakha R,Singh MK,et al.The cost of Pancreatoduodenectomy-an analysis of clinical determinants.Pancreatology2016;16:652-657.
[18]Lassen K,Coolsen MM,Slim K,Carli F,de Aguilar-Nascimento JE,Sch?fer M,et al.Guidelines for perioperative care for pancreaticoduodenectomy:Enhanced Recovery After Surgery(ERAS?)Society recommendations.World JSurg 2013;37:240-258.
[19]Bassi C,Marchegiani G,Dervenis C,Sarr M,Abu Hilal M,Adham M,et al.The2016 update of the International Study Group(ISGPS)definition and grading of postoperative pancreatic fistula:11 years after.Surgery 2017;161:584-591.
[20]Wente MN,Bassi C,Dervenis C,Fingerhut A,Gouma DJ,Izbicki JR,et al.Delayed gastric emptying(DGE)after pancreatic surgery:a suggested definition by the International Study Group of Pancreatic Surgery(ISGPS).Surgery2007;142:761-768.
[21]Wente MN,Veit JA,Bassi C,Dervenis C,Fingerhut A,Gouma DJ,et al.Postpancreatectomy hemorrhage(PPH):an International Study Group of Pancreatic Surgery(ISGPS)definition.Surgery 2007;142:20-25.
[22]Clavien PA,Strasberg SM.Severity grading of surgical complications.Ann Surg2009;250:197-198.
[23]Callery MP,Pratt WB,Kent TS,Chaikof EL,Vollmer CM Jr.A prospectively validated clinical risk score accurately predicts pancreatic fistula after pancreatoduodenectomy.J Am Coll Surg 2013;216:1-14.
[24]Kehlet H.Multimodal approach to postoperative recovery.Curr Opin Crit Care2009;15:355-358.
[25]Chaudhary A,Barreto SG,Talole SD,Singh A,Perwaiz A,Singh T.Early discharge after pancreatoduodenectomy:what helps and what prevents?Pancreas 2015;44:273-278.
[26]Pillai SA,Palaniappan R,Pichaimuthu A,Rajendran KK,Sathyanesan J,Govindhan M.Feasibility of implementing fast-track surgery in pancreaticoduodenectomy with pancreaticogastrostomy for reconstruction-a prospective cohort study with historical control.Int J Surg 2014;12:1005-1009.
[27]Balzano G,Zerbi A,Braga M,Rocchetti S,Beneduce AA,Di Carlo V.Fast-track recovery programme after pancreatico-duodenectomy reduces delayed gastric emptying.Br J Surg 2008;95:1387-1393.
[28]Robertson N,Gallacher PJ,Peel N,Garden OJ,Duxbury M,Lassen K,et al.Implementation of an enhanced recovery programme following pancreaticoduodenectomy.HPB(Oxford)2012;14:700-708.
[29]Zouros E,Liakakos T,Machairas A,Patapis P,Agalianos C,Dervenis C.Improvement of gastric emptying by enhanced recovery after pancreaticoduodenectomy.Hepatobiliary Pancreat Dis Int 2016;15:198-208.
[30]Shah OJ,Bangri SA,Singh M,Lattoo RA,Bhat MY,Khan FA.Impact of centralization of pancreaticoduodenectomy coupled with fast track recovery protocol:a comparative study from India.Hepatobiliary Pancreat Dis Int2016;15:546-552.
[31]Bai X,Zhang X,Lu F,Li G,Gao S,Lou J,et al.The implementation of an enhanced recovery after surgery(ERAS)program following pancreatic surgery in an academic medical center of China.Pancreatology 2016;16:665-670.
[32]Dai J,Jiang Y,Fu D.Reducing postoperative complications and improving clinical outcome:enhanced recovery after surgery in pancreaticoduodenectomya retrospective cohort study.Int J Surg 2017;39:176-181.
[33]Aviles C,Hockenberry M,Vrochides D,Iannitti D,Cochran A,Tezber K,et al.Perioperative care implementation:evidence-based practice for patients with pancreaticoduodenectomy using the enhanced recovery after surgery guidelines.Clin J Oncol Nurs 2017;21:466-472.
[34]Takagi K,Yoshida R,Yagi T,Umeda Y,Nobuoka D,Kuise T,et al.Effect of an enhanced recovery after surgery protocol in patients undergoing pancreaticoduodenectomy:A randomized controlled trial.Clin Nutr 2018 Jan 9.
[35]Lei Q,Wang X,Tan S,Wan X,Zheng H,Li N.Application of enhanced recovery after surgery program in perioperative management of pancreaticoduodenectomy:a systematic review.Zhonghua Wei Chang Wai Ke Za Zhi2015;18:143-149.
[36]Fisher WE,Hodges SE,Cruz G,Artinyan A,Silberfein EJ,Ahern CH,et al.Routine nasogastric suction may be unnecessary after a pancreatic resection.HPB(Oxford)2011;13:792-796.
[37]Kunstman JW,Klemen ND,Fonseca AL,Araya DL,Salem RR.Nasogastric drainage may be unnecessary after pancreaticoduodenectomy:a comparison of routine vs selective decompression.J Am Coll Surg 2013;217:4 81-4 88.
[38]Pashikanti L,Von Ah D.Impact of early mobilization protocol on the medical-surgical inpatient population:an integrated review of literature.Clin Nurse Spec 2012;26:87-94.
[39]Nicholson GA,Finlay IG,Diament RH,Molloy RG,Horgan PG,Morrison DS.Mechanical bowel preparation does not influence outcomes following colonic cancer resection.Br J Surg 2011;98:866-871.
[40]Koller SE,Bauer KW,Egleston BL,Smith R,Philp MM,Ross HM,et al.Comparative effectiveness and risks of bowel preparation before elective colorectal surgery.Ann Surg 2018;267:734-742.
[41]Lavu H,Kennedy EP,Mazo R,Stewart RJ,Greenleaf C,Grenda DR,et al.Preoperative mechanical bowel preparation does not offer a benefit for patients who undergo pancreaticoduodenectomy.Surgery 2010;148:278-284.
[42]Jakhetiya A,Shukla NK,Deo SV,Garg PK,Thulkar S.Deep vein thrombosis in indian cancer patients undergoing major thoracic and abdomino-pelvic surgery.Indian J Surg Oncol 2016;7:425-429.
[43]Rinehart J,Lilot M,Lee C,Joosten A,Huynh T,Canales C,et al.Closed-loop assisted versus manual goal-directed fluid therapy during high-risk abdominal surgery:a case-control study with propensity matching.Crit Care 2015;19:94.
[44]Bundgaard-Nielsen M,Secher NH,Kehlet H.’Liberal’vs.’restrictive’perioperative fluid therapy-a critical assessment of the evidence.Acta Anaesthesiol Scand 2009;53:843-851.
[45]Pesta?a D,Espinosa E,Eden A,Nájera D,Collar L,Aldecoa C,et al.Perioperative goal-directed hemodynamic optimization using noninvasive cardiac output monitoring in major abdominal surgery:a prospective,randomized,multicenter,pragmatic trial:POEMAS Study(PeriOperative goal-directed thErapy in Major Abdominal Surgery).Anesth Analg 2014;119:579-587.
[46]Mikor A,Trásy D,Németh MF,Osztroluczki A,Kocsi S,Kovács I,et al.Continuous central venous oxygen saturation assisted intraoperative hemodynamic management during major abdominal surgery:a randomized,controlled trial.BMC Anesthesiol 2015;15:82.
[47]Andrianello S,Marchegiani G,Bannone E,Masini G,Malleo G,Montemezzi GL,et al.Clinical implications of intraoperative fluid therapy in pancreatic surgery.J Gastrointest Surg 2018;22:2072-2079.
[48]Bernard H.Patient warming in surgery and the enhanced recovery.Br J Nurs2013;22:319-325.
[49]Campbell G,Alderson P,Smith AF,Warttig S.Warming of intravenous and irrigation fluids for preventing inadvertent perioperative hypothermia.Cochrane Database Syst Rev 2015;13(4):CD009891.doi:10.10 02/14651858.CD0 09891.
[50]Bergquist JR,Shubert CR,Ubl DS,Thiels CA,Kendrick ML,Truty MJ,et al.Risk by indication for pancreaticoduodenectomy in patients 80 years and older:a study from the American college of surgeons national surgical quality improvement program.HPB(Oxford)2016;18:900-907.
[51]Scheufele F,Schorn S,Demir IE,Sargut M,Tieftrunk E,Calavrezos L,et al.Preoperative biliary stenting versus operation first in jaundiced patients due to malignant lesions in the pancreatic head:a meta-analysis of current literature.Surgery 2017;161:939-950.
[52]Chen Y,Ou G,Lian G,Luo H,Huang K,Huang Y.Effect of preoperative biliary drainage on complications following pancreatoduodenectomy:a meta-analysis.Medicine(Baltimore)2015;94:e1199.
[2]Kehlet H,Dahl JB.Anaesthesia,surgery,and challenges in postoperative recovery.Lancet 2003;362:1921-1928.
[3]Gottschalk A,Sharma S,Ford J,Durieux ME,Tiouririne M.Review article:the role of the perioperative period in recurrence after cancer surgery.Anesth Analg 2010;110:1636-1643.
[4]Zhuang CL,Huang DD,Chen FF,Zhou CJ,Zheng BS,Chen BC,et al.Laparoscopic versus open colorectal surgery within enhanced recovery after surgery programs:a systematic review and meta-analysis of randomized controlled trials.Surg Endosc 2015;29:2091-2100.
[5]Wan KM,Carter J,Philp S.Predictors of early discharge after open gynecological surgery in the setting of an enhanced recovery after surgery protocol.JObstet Gynaecol Res 2016;42:1369-1374.
[6]Azhar RA,Bochner B,Catto J,Goh AC,Kelly J,Patel HD,et al.Enhanced Recovery after urological surgery:a contemporary systematic review of outcomes,key elements,and research needs.Eur Urol 2016;70:176-187.
[7]Thorell A,MacCormick AD,Awad S,Reynolds N,Roulin D,Demartines N,et al.Guidelines for perioperative care in bariatric surgery:Enhanced Recovery After Surgery(ERAS)Society recommendations.World J Surg2016;40:2065-2083.
[8]Melloul E,Hübner M,Scott M,Snowden C,Prentis J,Dejong CH,et al.Guidelines for perioperative care for liver surgery:Enhanced Recovery After Surgery(ERAS)Society recommendations.World J Surg 2016;40:2425-2440.
[9]Jeong O,Ryu SY,Park YK.Postoperative functional recovery after gastrectomy in patients undergoing enhanced recovery after surgery:a prospective assessment using standard discharge criteria.Medicine(Baltimore)2016;95:e3140.
[10]Xiong J,Szatmary P,Huang W,de la Iglesia-Garcia D,Nunes QM,Xia Q,et al.Enhanced recovery after surgery program in patients undergoing pancreaticoduodenectomy:a PRISMA-compliant systematic review and meta-analysis.Medicine(Baltimore)2016;95:e3497.
[11]Kagedan DJ,Ahmed M,Devitt KS,Wei AC.Enhanced recovery after pancreatic surgery:a systematic review of the evidence.HPB(Oxford)2015;17:11-16.
[12]Coolsen MM,van Dam RM,van der Wilt AA,Slim K,Lassen K,Dejong CH.Systematic review and meta-analysis of enhanced recovery after pancreatic surgery with particular emphasis on pancreaticoduodenectomies.World J Surg2013;37:1909-1918.
[13]Kawai M,Yamaue H.Analysis of clinical trials evaluating complications after pancreaticoduodenectomy:a new era of pancreatic surgery.Surg Today2010;40:1011-1017.
[14]Winter JM,Cameron JL,Campbell KA,Arnold MA,Chang DC,Coleman J,et al.1423 pancreaticoduodenectomies for pancreatic cancer:a single-institution experience.J Gastrointest Surg 2006;10:1199-1211.
[15]Raimondi S,Maisonneuve P,Lowenfels AB.Epidemiology of pancreatic cancer:an overview.Nat Rev Gastroenterol Hepatol 2009;6:699-708.
[16]Enestvedt CK,Diggs BS,Cassera MA,Hammill C,Hansen PD,Wolf RF.Complications nearly double the cost of care after pancreaticoduodenectomy.Am JSurg 2012;204:332-338.
[17]Barreto SG,Singh A,Perwaiz A,Singh T,Adlakha R,Singh MK,et al.The cost of Pancreatoduodenectomy-an analysis of clinical determinants.Pancreatology2016;16:652-657.
[18]Lassen K,Coolsen MM,Slim K,Carli F,de Aguilar-Nascimento JE,Sch?fer M,et al.Guidelines for perioperative care for pancreaticoduodenectomy:Enhanced Recovery After Surgery(ERAS?)Society recommendations.World JSurg 2013;37:240-258.
[19]Bassi C,Marchegiani G,Dervenis C,Sarr M,Abu Hilal M,Adham M,et al.The2016 update of the International Study Group(ISGPS)definition and grading of postoperative pancreatic fistula:11 years after.Surgery 2017;161:584-591.
[20]Wente MN,Bassi C,Dervenis C,Fingerhut A,Gouma DJ,Izbicki JR,et al.Delayed gastric emptying(DGE)after pancreatic surgery:a suggested definition by the International Study Group of Pancreatic Surgery(ISGPS).Surgery2007;142:761-768.
[21]Wente MN,Veit JA,Bassi C,Dervenis C,Fingerhut A,Gouma DJ,et al.Postpancreatectomy hemorrhage(PPH):an International Study Group of Pancreatic Surgery(ISGPS)definition.Surgery 2007;142:20-25.
[22]Clavien PA,Strasberg SM.Severity grading of surgical complications.Ann Surg2009;250:197-198.
[23]Callery MP,Pratt WB,Kent TS,Chaikof EL,Vollmer CM Jr.A prospectively validated clinical risk score accurately predicts pancreatic fistula after pancreatoduodenectomy.J Am Coll Surg 2013;216:1-14.
[24]Kehlet H.Multimodal approach to postoperative recovery.Curr Opin Crit Care2009;15:355-358.
[25]Chaudhary A,Barreto SG,Talole SD,Singh A,Perwaiz A,Singh T.Early discharge after pancreatoduodenectomy:what helps and what prevents?Pancreas 2015;44:273-278.
[26]Pillai SA,Palaniappan R,Pichaimuthu A,Rajendran KK,Sathyanesan J,Govindhan M.Feasibility of implementing fast-track surgery in pancreaticoduodenectomy with pancreaticogastrostomy for reconstruction-a prospective cohort study with historical control.Int J Surg 2014;12:1005-1009.
[27]Balzano G,Zerbi A,Braga M,Rocchetti S,Beneduce AA,Di Carlo V.Fast-track recovery programme after pancreatico-duodenectomy reduces delayed gastric emptying.Br J Surg 2008;95:1387-1393.
[28]Robertson N,Gallacher PJ,Peel N,Garden OJ,Duxbury M,Lassen K,et al.Implementation of an enhanced recovery programme following pancreaticoduodenectomy.HPB(Oxford)2012;14:700-708.
[29]Zouros E,Liakakos T,Machairas A,Patapis P,Agalianos C,Dervenis C.Improvement of gastric emptying by enhanced recovery after pancreaticoduodenectomy.Hepatobiliary Pancreat Dis Int 2016;15:198-208.
[30]Shah OJ,Bangri SA,Singh M,Lattoo RA,Bhat MY,Khan FA.Impact of centralization of pancreaticoduodenectomy coupled with fast track recovery protocol:a comparative study from India.Hepatobiliary Pancreat Dis Int2016;15:546-552.
[31]Bai X,Zhang X,Lu F,Li G,Gao S,Lou J,et al.The implementation of an enhanced recovery after surgery(ERAS)program following pancreatic surgery in an academic medical center of China.Pancreatology 2016;16:665-670.
[32]Dai J,Jiang Y,Fu D.Reducing postoperative complications and improving clinical outcome:enhanced recovery after surgery in pancreaticoduodenectomya retrospective cohort study.Int J Surg 2017;39:176-181.
[33]Aviles C,Hockenberry M,Vrochides D,Iannitti D,Cochran A,Tezber K,et al.Perioperative care implementation:evidence-based practice for patients with pancreaticoduodenectomy using the enhanced recovery after surgery guidelines.Clin J Oncol Nurs 2017;21:466-472.
[34]Takagi K,Yoshida R,Yagi T,Umeda Y,Nobuoka D,Kuise T,et al.Effect of an enhanced recovery after surgery protocol in patients undergoing pancreaticoduodenectomy:A randomized controlled trial.Clin Nutr 2018 Jan 9.
[35]Lei Q,Wang X,Tan S,Wan X,Zheng H,Li N.Application of enhanced recovery after surgery program in perioperative management of pancreaticoduodenectomy:a systematic review.Zhonghua Wei Chang Wai Ke Za Zhi2015;18:143-149.
[36]Fisher WE,Hodges SE,Cruz G,Artinyan A,Silberfein EJ,Ahern CH,et al.Routine nasogastric suction may be unnecessary after a pancreatic resection.HPB(Oxford)2011;13:792-796.
[37]Kunstman JW,Klemen ND,Fonseca AL,Araya DL,Salem RR.Nasogastric drainage may be unnecessary after pancreaticoduodenectomy:a comparison of routine vs selective decompression.J Am Coll Surg 2013;217:4 81-4 88.
[38]Pashikanti L,Von Ah D.Impact of early mobilization protocol on the medical-surgical inpatient population:an integrated review of literature.Clin Nurse Spec 2012;26:87-94.
[39]Nicholson GA,Finlay IG,Diament RH,Molloy RG,Horgan PG,Morrison DS.Mechanical bowel preparation does not influence outcomes following colonic cancer resection.Br J Surg 2011;98:866-871.
[40]Koller SE,Bauer KW,Egleston BL,Smith R,Philp MM,Ross HM,et al.Comparative effectiveness and risks of bowel preparation before elective colorectal surgery.Ann Surg 2018;267:734-742.
[41]Lavu H,Kennedy EP,Mazo R,Stewart RJ,Greenleaf C,Grenda DR,et al.Preoperative mechanical bowel preparation does not offer a benefit for patients who undergo pancreaticoduodenectomy.Surgery 2010;148:278-284.
[42]Jakhetiya A,Shukla NK,Deo SV,Garg PK,Thulkar S.Deep vein thrombosis in indian cancer patients undergoing major thoracic and abdomino-pelvic surgery.Indian J Surg Oncol 2016;7:425-429.
[43]Rinehart J,Lilot M,Lee C,Joosten A,Huynh T,Canales C,et al.Closed-loop assisted versus manual goal-directed fluid therapy during high-risk abdominal surgery:a case-control study with propensity matching.Crit Care 2015;19:94.
[44]Bundgaard-Nielsen M,Secher NH,Kehlet H.’Liberal’vs.’restrictive’perioperative fluid therapy-a critical assessment of the evidence.Acta Anaesthesiol Scand 2009;53:843-851.
[45]Pesta?a D,Espinosa E,Eden A,Nájera D,Collar L,Aldecoa C,et al.Perioperative goal-directed hemodynamic optimization using noninvasive cardiac output monitoring in major abdominal surgery:a prospective,randomized,multicenter,pragmatic trial:POEMAS Study(PeriOperative goal-directed thErapy in Major Abdominal Surgery).Anesth Analg 2014;119:579-587.
[46]Mikor A,Trásy D,Németh MF,Osztroluczki A,Kocsi S,Kovács I,et al.Continuous central venous oxygen saturation assisted intraoperative hemodynamic management during major abdominal surgery:a randomized,controlled trial.BMC Anesthesiol 2015;15:82.
[47]Andrianello S,Marchegiani G,Bannone E,Masini G,Malleo G,Montemezzi GL,et al.Clinical implications of intraoperative fluid therapy in pancreatic surgery.J Gastrointest Surg 2018;22:2072-2079.
[48]Bernard H.Patient warming in surgery and the enhanced recovery.Br J Nurs2013;22:319-325.
[49]Campbell G,Alderson P,Smith AF,Warttig S.Warming of intravenous and irrigation fluids for preventing inadvertent perioperative hypothermia.Cochrane Database Syst Rev 2015;13(4):CD009891.doi:10.10 02/14651858.CD0 09891.
[50]Bergquist JR,Shubert CR,Ubl DS,Thiels CA,Kendrick ML,Truty MJ,et al.Risk by indication for pancreaticoduodenectomy in patients 80 years and older:a study from the American college of surgeons national surgical quality improvement program.HPB(Oxford)2016;18:900-907.
[51]Scheufele F,Schorn S,Demir IE,Sargut M,Tieftrunk E,Calavrezos L,et al.Preoperative biliary stenting versus operation first in jaundiced patients due to malignant lesions in the pancreatic head:a meta-analysis of current literature.Surgery 2017;161:939-950.
[52]Chen Y,Ou G,Lian G,Luo H,Huang K,Huang Y.Effect of preoperative biliary drainage on complications following pancreatoduodenectomy:a meta-analysis.Medicine(Baltimore)2015;94:e1199.