Perioperative Care with Fast-Track Management in Patients Undergoing Pancreaticoduodenectomy
- VernacularTitle:Нойр булчирхай, дээрх гэдэс тайрах мэс заслын үе дэх шуурхай-хяналт эмчилгээний удирдамж
- Author:
Shinjiro Kobayashi
;
Takehito Otsubo
- Collective Name:Marianna University School of Medicine
- Publication Type:journal article
- From:Innovation
2014;8(4):120-121
- CountryMongolia
- Language:English
-
Abstract:
Background: It has been considered that allowing patients to return to daily
life earlier after surgery helps recovery of physiological function and reduces
postoperative complications and hospital stay. We investigated the usefulness
of Fast-Track management in perioperative care of patients undergoing
pancreaticoduodenectomy (PD).
Methods: Patients (n = 90) who received conventional perioperative management
from 2005 to 2009 were included as the ‘conventional group’ (historical control
group),
and patients who received perioperative care with Fast-Track management (n
= 87) from 2010 to 2013 were included as the ‘fast-track group’. To evaluate
the efficacy of perioperative care with fast-track management,the incidence
of postoperative complications and the length of hospital stay were compared
between the two groups (comparative study). For statistical analysis, univariate
analysis was performed using the v2 test or Fisher’s exact test.
Results: There was no significant difference between the two groups in sex, mean
age, presence/absence of diabetes mellitus, preoperative drainage for jaundice,
previous disease, operative procedure, mean duration of operation, or blood loss
(p=0.01). The incidence of surgical site infection in the conventional group and
fast-track group was 28.9 and 14.0 %, respectively, with a significant difference
between the two groups (p = 0.019). In addition, the incidence of pancreatic
fistula (grade B, C) significantlydiffered between the two groups (27.8 % in
the conventional group, 9.0 % in the fast-track group; p = 0.001). The mean
postoperative hospital stay was 36.3 days in the conventional group and 21.9
days in the fast-track group (p=0.001).
Conclusions: Perioperative care with fast-track management may reduce
postoperative complications and decrease the length of hospital stay in patients
undergoing PD.
