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
- 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 dailylife earlier after surgery helps recovery of physiological function and reducespostoperative complications and hospital stay. We investigated the usefulnessof Fast-Track management in perioperative care of patients undergoingpancreaticoduodenectomy (PD).Methods: Patients (n = 90) who received conventional perioperative managementfrom 2005 to 2009 were included as the ‘conventional group’ (historical controlgroup),and patients who received perioperative care with Fast-Track management (n= 87) from 2010 to 2013 were included as the ‘fast-track group’. To evaluatethe efficacy of perioperative care with fast-track management,the incidenceof postoperative complications and the length of hospital stay were comparedbetween the two groups (comparative study). For statistical analysis, univariateanalysis was performed using the v2 test or Fisher’s exact test.Results: There was no significant difference between the two groups in sex, meanage, 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 andfast-track group was 28.9 and 14.0 %, respectively, with a significant differencebetween the two groups (p = 0.019). In addition, the incidence of pancreaticfistula (grade B, C) significantlydiffered between the two groups (27.8 % inthe conventional group, 9.0 % in the fast-track group; p = 0.001). The meanpostoperative hospital stay was 36.3 days in the conventional group and 21.9days in the fast-track group (p=0.001).Conclusions: Perioperative care with fast-track management may reducepostoperative complications and decrease the length of hospital stay in patientsundergoing PD.
