The role of fast-track surgery in pancreaticoduodenectomy: a retrospective cohort study of 635 consecutive resections.

Background: Pancreaticoduodenectomy (PD) is one of the most difficult and dangerous operations in general surgery. This study used the concept of fast-track surgery (FTS) technique, which involves pain control, early enteral nutrition and other measures during the preoperative period, to evaluate the rate of complications and shorter hospitalization.

Methods: This retrospective, observational study was conducted between January 2009 and January 2013. A total of 635 patients underwent PD in the Department of Pancreatic Surgery at ChangHai Hospital (Shanghai, China). 325 patients had FTS and 310 patients received the traditional pathway of treatment. The incidence of postoperative complications, the serum albumin level, expenses, postoperative hospitalization, and readmission rates were compared.

Results: There were no significant differences in the blood transfusion volume, nasogastric intubation, and readmission rates (p > 0.05). However, the FTS group had less postoperative hospitalization, fewer expenses and a lower incidence of postoperative complications compared with the control group (p<0.05).

Conclusion: Pancreaticoduodenectomy can be further optimized by the use of FTS methods, which can reduce the incidence of in hospital postoperative complications and expenses without increasing the risk of readmission.