No abstract

The relevance of routine preoperative echocardiographic examination in patients scheduled for adrenalectomy for pheochromocytoma, who have no cardiac symptoms or clinical evidence of cardiac involvement, is questionable.

No abstract

duodenopancreatectomies of the pre-ERAS era, perioperative data was assessed retrospectively. Results: The ERAS-protocol could be successfully implemented for pancreatic surgery in our hospital, the adherence to the protocol starting from 24.0% in the pre-ERAS era constantly increased to 67.9% in 2018. Regarding the different perioperative phases, the adherence is highest in the pre-operative phase: 94%, still 82% in the intra-operative phase but just 38% in the regarding the postoperative phase. Nevertheless, by the implementation of an ERAS-protocol in pancreatic surgery, median length of stay could be reduced by 4.4 days (19.3 vs. 14.9d) as well as severe complications by 5.5% (CDIIIa: 36.1 vs. 30.6%) without negatively affecting the readmission rate (11.1 vs. 7.4%). Pancreatic fistulas could be reduced by 6.5% (22.2 vs 15.7%), as well as postoperative obstipation by 9.4% (11.1 vs 1.7%). Evaluation of ASA and PPOS-SUM-Score indicates even patients of a slightly higher perioperative risk in the ERAS-group. Conclusion:The implementation of an ERAS-program for pancreatic surgery is feasible and successful. Pure extrapolation of data from other ERAS organ protocols is not sufficient. To further develop the ERAS-program we need to make sure that we are part of the same ERAS program. If everybody establishes its own modified ERAS-protocol, ERAS will not be more than a pure marketing tool.