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Patients treated with enhanced recovery after surgery protocol: preadmission counselling, preoperative immunonutrition, no preoperative bowel preparation, epidural analgesia with naropin + sufentanil, no pre-anesthetic medication, intraoperative iv fluid restriction, PONV prophylaxis with ondansetron + dexamethasone, hypothermia prophylaxis, removal of nasogastric tube (NGT) at the end of surgery, postoperative mobilization program, solid food diet from POD 2, early stop of iv infusions and removal of urinary catheter.

Patients treated with standard care perioperative protocol: epidural analgesia with naropin + sufentanil, pre-anesthetic medication with diazepam, Preoperative bowel preparation with sodium phosphate, removal of nasogastric tube on POD 1, solid food diet from POD 4

ERAS items implemented were: preadmission counselling, preoperative immunonutrition, no preoperative bowel preparation, epidural analgesia, no pre-anesthetic medication, intraoperative iv fluid restriction, PONV and hypothermia prophylaxis, removal of nasogastric tube (NGT) at the end of surgery, mobilization protocol, solid food diet from POD 2, early stop of iv infusions and removal of urinary catheter.

Enhanced recovery after surgery protocol

Epidural analgesia, pre-anesthetic medication with diazepam, bowel preparation with oral assumption of sodium phosphate, removal of nasogastric tube on POD 1, solid food diet from POD 4

Standard perioperative care

Postoperative nausea and vomiting prophylaxis with Ondansetron + Dexamethasone.

PONV prophylaxis with Ondansetron + Dexamethasone

Patient mobilization for 2 hours on first postoperative day Patient mobilization for 4 hours on first postoperative day + assisted deambulation in the room Patient mobilization for 6 hours on first postoperative day + assisted deambulation in the ward

Postoperative mobilization program

Midthoracic epidural analgesia with naropin 0.2 % plus sufentanil 0,5 mcg/mL

Epidural analgesia with naropin + sufentanil

Pre-anesthetic medication with diazepam

Patient multidisciplinary preoperative counselling, including anesthesiologist, surgeon and nurse.

Preadmission counselling

Preoperative bowel preparation with oral assumption of sodium phosphate

Preoperative bowel preparation with sodium phosphate

Marco Braga, MD

The purpose of this study is to assess the adherence to an enhanced recovery after surgery (ERAS) pathway and the impact of the ERAS protocol on postoperative short-term outcome in patients undergoing pancreaticoduodenectomy (PD).

A specific enhanced recovery after surgery (ERAS) protocol has been applied since October 2010 in consecutive patients undergoing pancreaticoduodenectomy (PD) in a high volume Institution. Patient compliance for each item has been assessed. Each ERAS patient was matched with a patient who received standard perioperative care. Match criteria were age, gender, malignant / benign disease, and PD prognostic score.

Safety and Feasibility Study of Enhanced Recovery in Pancreaticoduodenectomy

Safety and Feasibility Study of an Enhanced Recovery After Surgery Protocol in Patients Undergoing Elective Pancreaticoduodenectomy.

Adherence to single items of the pathway.

Comparison of postoperative morbidity and mortality, length of hospital stay, readmission.

Ospedale San Raffaele

Università Vita-Salute San Raffaele

Professor in Surgery

Study title	NCT ID	Conditions	Interventions	Eligibility	Organization	Link
Safety and Feasibility Study of Enhanced Recovery in Pancreaticoduodenectomy	NCT01759706	Pancreatic Neop...	Enhanced recove... Standard periop... PONV prophylaxi... Postoperative m... Epidural analge... Pre-anesthetic ... Preadmission co... Preoperative bo...	18 Years - 85 Years	Università Vita-Salute San Raffaele
Safety and Feasibility Study of Enhanced Recovery in Pancreaticoduodenectomy	NCT01759706	Pancreatic Neop...	Enhanced recove... Standard periop... PONV prophylaxi... Postoperative m... Epidural analge... Pre-anesthetic ... Preadmission co... Preoperative bo...	18 Years - 85 Years	Università Vita-Salute San Raffaele

Spots Global Cancer Trial Database for preoperative bowel preparation with sodium phosphate