Early surgery with a ‘fast track’ pathway for periampullary malignancy is associated with an increased rate of pancreatoduodenectomy and reduced costs

Abstract

p = 0.59), pathological diagnosis (66% vs 71% pancreatic adenocarcinoma), vascular reconstruction (13% vs 14%, p = 0.857) or Charlson score (5.3 vs 4.7, p = 0.820). Pancreatic texture and duct diameter were similar. One mortality occurred in the ERAS group.The incidence of postoperative complications was identical. Grade B or C pancreatic fistulation occurred in 19% of patients in each group (p = 0.97) whilst delayed gastric emptying occurred in 22.2% vs 19.1% (p = 0.77). Unplanned readmissions was comparable (34.3% vs 38.6% p = 0.81) as was length of stay (18.8 days vs 17.7 days, p = 0.59). Conclusion: The implementation of an ERAS protocol failed to reduce the incidence of complications, unplanned readmissions or decrease the length of stay in patients undergoing PD.