Introduction: The Enhanced Recovery After Surgery (ERAS) protocol represents an advancement in perioperative care to reduce surgical stress and accelerate recovery. This meta-analysis evaluates the effectiveness of ERAS in pancreatic surgery.
Objective: To assess the impact of the ERAS protocol compared with conventional hospital care on postoperative outcomes, including length of hospital stay (LOS), hospital costs, readmission rates, and infection rates in patients undergoing pancreatic surgery.
Methods: A systematic review and meta-analysis of randomized controlled trials (RCTs) followed PRISMA guidelines. We searched PubMed, Cochrane Central Register of Controlled Trials, and Embase to identify relevant RCTs. Data were extracted and analyzed using a random-effects model. Statistical analyses were performed using RStudio.
Results: Seven RCTs involving 731 patients were included. The meta-analysis showed a statistically significant reduction in LOS by 2.49 days (MD = -2.49; 95% CI [-4.20; -0.79]; p < 0.01) with considerable heterogeneity (I = 86%). Hospital costs were significantly reduced (SMD = -0.36; 95% CI [-0.65; -0.06]; p = 0.02) with moderate heterogeneity (I = 52%). Readmission and infection rates showed no statistically significant differences between ERAS and control groups. Egger's test indicated no significant publication bias.
Conclusion: The ERAS protocol significantly reduces LOS and hospital costs in pancreatic surgery patients. These findings support the implementation of ERAS protocols to enhance recovery and optimize outcomes. Our study is the first to demonstrate these results using an RCT-only meta-analytic approach in pancreatic surgery, highlighting the value of ERAS in improving perioperative care.
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