On some crucial issues in the perioperative practice of enhanced recovery after surgery (ERAS) for pancreaticoduodenectomy
10.3760/cma.j.cn113855-20241007-00610
- VernacularTitle:胰十二指肠切除围手术期加速康复值得重视的若干热点问题
- Author:
Hao HU
1
;
Yinmo YANG
Author Information
1. 北京大学第一医院肝胆胰外科，北京 100034
- Keywords:
Pancreaticoduodenectomy;
Enhanced recovery after surgery;
Perioperative management
- From:
Chinese Journal of General Surgery
2024;39(11):817-821
- CountryChina
- Language:Chinese
-
Abstract:
In recent years, the concept and pathways of enhanced recovery after surgery (ERAS) have been extensively applied in abdominal surgery. Pancreaticoduodenectomy (PD), as a major surgical procedure, is characterized by its complexity, prolonged operative time, high complication rate, and slow postoperative recovery. The adoption of ERAS principles and pathways in the perioperative management of PD has been relatively delayed. In addition to general concerns such as prehabilitation, fluid management, nutritional support, and multimodal analgesia, some specific issues unique to pancreatic surgery, including the necessity and duration of postoperative gastrointestinal decompression and abdominal drainage, as well as postoperative dietary management, is what really demanding special consideration. Although high-quality studies, both domestic and international, have demonstrated the safety of ERAS, its adherence in clinical practice remains limited, and controversies regarding their implementation persist. Particularly in the context of the widespread adoption of minimally invasive surgery, it is imperative to explore strategies that maximize the advantages of minimally invasive surgery and ERAS, while balancing the general principles of perioperative management with the considerations specific to pancreatic surgery, thereby optimizing patient outcomes. This review provides an overview of the current status and recent advances in the application of ERAS during the perioperative period of PD, with the aim of promoting their standardized and rational implementation.
