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Clinical outcomes of Enhanced Recovery after Surgery Protocol for Hepato- pancreato- biliary Surgery; A Five-Year Experience from a Hellenic Oncological Hospital ERAS protocol and HPB surgery

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Published: Jul 7, 2022
DOI: https://doi.org/10.12681/healthresj.28616
Keywords:
cost-effectiveness eras program fast track protocol liver and pancreatic surgery
Maria Kapritsou
Hellenic Anticancer Oncological Hospital “Saint Savvas’’ Athens, Greece
https://orcid.org/0000-0002-8187-4978
Evan Alexandrou
2. 1Centre for Applied Nursing Research, Western Sydney University, Australia, 2 Department of Intensive Care, Liverpool Hospital, Australia, 3Alliance for Vascular Access Teaching and Research Group, Menzies Health Institute Queensland, Griffith University, Australia
https://orcid.org/0000-0001-7428-872X
Evangelos A Konstantinou
Professor of Nursing Anesthesiology and Vascular Access. Department of Nursing National and Kapodistrian University of Athens, Greece.
Margarita Giannakopoulou
Professor. Department of Nursing, National and Kapodistrian University of Athens, Greece
Nikolaos Fyrfiris
Consultant Anaesthesiologist. Hellenic Anticancer ‘’Saint Savvas’’ Hospital, Athens, Greece
Dimitrios P Korkolis
Director of Surgical Oncological Clinic, Hellenic Anticancer ‘’Saint Savvas’’ Hospital, Athens, Greece
Abstract

Background: The development of enhanced recovery after surgery protocols (ERAS) for surgical intervention has contributed to reducing hospital length of stay and improved patient outcomes. Aim of the study was the assessment of the recovery time and cost-effectiveness of an ERAS protocol in oncological patients undergoing hepato- pancreato- biliary surgery (HPB) compared to conventional (CON) care.

Methods: This prospective, open label, randomized trial, enrolled 283 patients who required hepatectomy or pancreatoduodenectomy. Eligible patients were stratified into hepatectomy or pancreatectomy groups then, randomly assigned to ERAS protocol (intervention) or CON care (control). The primary outcome of interest was post-operative recovery time (composite of; time to mobilization and oral intake) and secondary outcomes were cost effectiveness, dependance on post-operative opioids and post-operative complications (using the Clavien- Dindo classification).

Results: The rate of complications for the patients underwent hepatectomy and treated in ERAS group was 18.18% compared to CON group, which was 40.9%. Whilst, of complications for the patients underwent pancreatectomy and treated in ERAS group was 15.94% compared to CON group, which was 38.2%.

Conclusions: The ERAS protocol in this study significantly improved post-operative recovery time, reduced opioid dependance and reduced post-operative complications in patients undergoing HPB surgery.

 

 

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