Implementation of enhanced recovery programme for laparoscopic distal pancreatectomy: feasibility, safety and cost analysis
Implementation of enhanced recovery programme for laparoscopic distal pancreatectomy: feasibility, safety and cost analysis
Background/objectives
The adoption of laparoscopy for distal pancreatectomy has proven to substantially improve short-term outcomes. Stress response after major surgery can be further minimized within an enhanced recovery programme (ERP). However, data on the potential benefit of an ERP for laparoscopic distal pancreatectomy are still lacking. The aim was to assess the feasibility, safety and cost of ERP for patients undergoing laparoscopic distal pancreatectomy.
Methods
This is a case-control study from a Tertiary University Hospital. Sixty-six consecutive patients who underwent laparoscopic distal pancreatectomy were analyzed. Twenty-two patients were enrolled for the ERP and compared with previous consecutive 44 patients managed traditionally (1:2 ratio). Operative details, post-operative outcome and cost analysis were compared in the two groups.
Results
Patients enrolled in the ERP had similar intraoperative blood loss (median 165 ml vs. 200 ml; p = 0.176), operation time (225min vs. 210min; p = 0.633), time to remove naso-gastric tube (1 vs. 1 day; p = 0.081) but significantly shorter time to mobilization (median 1 vs. 2 days; p = 0.0001), start solid diet (2 vs. 3 days; p = 0004), and pass stools (3 vs. 5 days; p = 0.002) compared to the control group. Median length of stay was significantly shorter in the ERP group (3 vs. 6 days; p < 0.0001). No significant difference in readmission or complication rate was observed. Cost analysis was significantly in favor of the ERP group (p = 0.0004).
Conclusions
Implementation of ERP optimizes outcomes for laparoscopic distal pancreatectomy with significant earlier return to normal gut function, reduced length of stay and cost saving.
185-190
Richardson, John
b396f3bb-cb5f-42c6-a559-707a5a541d67
Di Fabio, Francesco
5318ae30-aac4-49ab-b11c-289ae2049cdf
Clarke, Hannah
fcec7849-1d6e-4b3b-a323-70e325c7a89d
Bajalan, Mohammed
0a2697cd-c19a-4242-bad2-3b69a90d0549
Davids, Joe
bc68d9af-a034-4b41-8a32-543252479aca
Abu Hilal, Mohammed
384e1c60-8519-4eed-8e92-91775aad4c47
March 2015
Richardson, John
b396f3bb-cb5f-42c6-a559-707a5a541d67
Di Fabio, Francesco
5318ae30-aac4-49ab-b11c-289ae2049cdf
Clarke, Hannah
fcec7849-1d6e-4b3b-a323-70e325c7a89d
Bajalan, Mohammed
0a2697cd-c19a-4242-bad2-3b69a90d0549
Davids, Joe
bc68d9af-a034-4b41-8a32-543252479aca
Abu Hilal, Mohammed
384e1c60-8519-4eed-8e92-91775aad4c47
Richardson, John, Di Fabio, Francesco, Clarke, Hannah, Bajalan, Mohammed, Davids, Joe and Abu Hilal, Mohammed
(2015)
Implementation of enhanced recovery programme for laparoscopic distal pancreatectomy: feasibility, safety and cost analysis.
Pancreatology, 15 (2), .
(doi:10.1016/j.pan.2015.01.002).
(PMID:25641674)
Abstract
Background/objectives
The adoption of laparoscopy for distal pancreatectomy has proven to substantially improve short-term outcomes. Stress response after major surgery can be further minimized within an enhanced recovery programme (ERP). However, data on the potential benefit of an ERP for laparoscopic distal pancreatectomy are still lacking. The aim was to assess the feasibility, safety and cost of ERP for patients undergoing laparoscopic distal pancreatectomy.
Methods
This is a case-control study from a Tertiary University Hospital. Sixty-six consecutive patients who underwent laparoscopic distal pancreatectomy were analyzed. Twenty-two patients were enrolled for the ERP and compared with previous consecutive 44 patients managed traditionally (1:2 ratio). Operative details, post-operative outcome and cost analysis were compared in the two groups.
Results
Patients enrolled in the ERP had similar intraoperative blood loss (median 165 ml vs. 200 ml; p = 0.176), operation time (225min vs. 210min; p = 0.633), time to remove naso-gastric tube (1 vs. 1 day; p = 0.081) but significantly shorter time to mobilization (median 1 vs. 2 days; p = 0.0001), start solid diet (2 vs. 3 days; p = 0004), and pass stools (3 vs. 5 days; p = 0.002) compared to the control group. Median length of stay was significantly shorter in the ERP group (3 vs. 6 days; p < 0.0001). No significant difference in readmission or complication rate was observed. Cost analysis was significantly in favor of the ERP group (p = 0.0004).
Conclusions
Implementation of ERP optimizes outcomes for laparoscopic distal pancreatectomy with significant earlier return to normal gut function, reduced length of stay and cost saving.
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More information
e-pub ahead of print date: 20 January 2015
Published date: March 2015
Organisations:
Cancer Sciences
Identifiers
Local EPrints ID: 400320
URI: http://eprints.soton.ac.uk/id/eprint/400320
ISSN: 1424-3903
PURE UUID: 9d7e3a49-5f79-44c7-8aec-46579b09356c
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Date deposited: 14 Sep 2016 13:41
Last modified: 15 Mar 2024 02:14
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Contributors
Author:
John Richardson
Author:
Francesco Di Fabio
Author:
Hannah Clarke
Author:
Mohammed Bajalan
Author:
Joe Davids
Author:
Mohammed Abu Hilal
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