Guidelines for perioperative care for pancreaticoduodenectomy: Enhanced Recovery After Surgery (ERAS®) Society recommendations

被引：357

作者：

Lassen, Kristoffer ^{[1
,2
,3
]}

Coolsen, Marielle M. E. ^{[4
,5
]}

Slim, Karem ^{[6
]}

Carli, Francesco ^{[7
]}

de Aguilar-Nascimento, Jose E. ^{[8
]}

Schaefer, Markus ^{[9
]}

Parks, Rowan W. ^{[3
]}

Fearon, Kenneth C. H. ^{[3
]}

Lobo, Dileep N. ^{[10
]}

Demartines, Nicolas ^{[9
]}

Braga, Marco ^{[11
]}

Ljungqvist, Olle ^{[12
,13
]}

Dejong, Cornelis H. C. ^{[4
,5
]}

机构：

[1] Univ Hosp No Norway, Dept GI & HPB Surg, Tromso, Norway

[2] Univ Tromso, Inst Clin Med, N-9001 Tromso, Norway

[3] Univ Edinburgh, Royal Infirm Edinburgh, Edinburgh EH8 9YL, Midlothian, Scotland

[4] Univ Hosp Maastricht, Dept Surg, Maastricht, Netherlands

[5] NUTRIM Sch Nutr Toxicol & Metab, Maastricht, Netherlands

[6] Hosp CHU Estaing, Dept Digest Surg, Clermont Ferrand, France

[7] McGill Univ, Ctr Hlth, Dept Anesthesia, Montreal, PQ, Canada

[8] Univ Fed Mato Grosso, Dept Surg, Cuiaba, Brazil

[9] Univ Hosp Lausanne CHUV, Dept Visceral Surg, Lausanne, Switzerland

[10] Univ Nottingham Hosp, Queens Med Ctr, Nottingham Digest Dis Ctr,Natl Inst Hlth Res, Div Gastrointestinal Surg,Biomed Res Unit, Nottingham NG7 2UH, England

[11] San Raffaele Univ, Milan, Italy

[12] Orebro Univ Hosp, Dept Surg, Orebro, Sweden

[13] Karolinska Inst, Dept Mol Med & Surg, Stockholm, Sweden

来源：

CLINICAL NUTRITION | 2012年 / 31卷 / 06期

关键词：

Enhanced Recovery After Surgery (ERAS); Pancreatoduodenectomy; Whipple; Fast track; Critical pathway; Guidelines; Pancreas; PREOPERATIVE BILIARY DRAINAGE; RANDOMIZED CLINICAL-TRIAL; ELECTIVE COLORECTAL SURGERY; ROUTINE NASOGASTRIC DECOMPRESSION; POSTOPERATIVE INSULIN-RESISTANCE; UPPER-GASTROINTESTINAL SURGERY; CIRCULATING-WATER GARMENT; SURGICAL SITE INFECTIONS; URINARY-TRACT-INFECTION; EPIDURAL ANALGESIA;

D O I：

10.1016/j.clnu.2012.08.011

中图分类号：

R15 [营养卫生、食品卫生]; TS201 [基础科学];

学科分类号：

100403 ;

摘要：

Background & aims: Protocols for enhanced recovery provide comprehensive and evidence-based guidelines for best perioperative care. Protocol implementation may reduce complication rates and enhance functional recovery and, as a result of this, also reduce length-of-stay in hospital. There is no comprehensive framework available for pancreaticoduodenectomy. Methods: An international working group constructed within the Enhanced Recovery After Surgery (ERAS (R)) Society constructed a comprehensive and evidence-based framework for best perioperative care for pancreaticoduodenectomy patients. Data were retrieved from standard databases and personal archives. Evidence and recommendations were classified according to the GRADE system and reached through consensus in the group. The quality of evidence was rated "high", "moderate", "low" or "very low". Recommendations were graded as "strong" or "weak". Results: Comprehensive guidelines are presented. Available evidence is summarised and recommendations given for 27 care items. The quality of evidence varies substantially and further research is needed for many issues to improve the strength of evidence and grade of recommendations. Conclusions: The present evidence-based guidelines provide the necessary platform upon which to base a unified protocol for perioperative care for pancreaticoduodenectomy. A unified protocol allows for comparison between centres and across national borders. It facilitates multi-institutional prospective cohort registries and adequately powered randomised trials. (C) 2012 Elsevier Ltd and European Society for Clinical Nutrition and Metabolism. All rights reserved.

引用

页码：817 / 830

页数：14

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