Ultrasound monitoring at the stages of cryoablation of the hepato-pancreato-biliary’s neoplasms

Abstract

Aims: ERAS program was initialy developped in colorectal surgery. It is a multidisciplinary approach focus on the patient which include surgeons, anesthesists, nurses and physiotherapeutists. In 2013, the ERAS group published recommandations for pancreatic surgery. Metaanalyses reported, in pancreatic surgery, decreased length of hospital stay with less morbidity and less mortality when compared to traditionnal care. The aim of our study was to evaluate the outcomes after ERAS implementation in pancreatic surgery in Edouard Herriot Hospital, Lyon. Methods: In our center, we started implementation of ERAS in pancreatic surgery in january 2014. We decided to perform a comparative study between patients who had received traditionnal care in 2013 and patients who had received ERAS program in 2014. We evaluated the morbidity, the mortality and the length of hospital stay. Results: 38 patients were included in ERAS group in 2014 and 48 patients were included in traditional care group in 2013. The rate of compliance in ERAS group was high (> 70%). Median length of hospital stay was significantly reduced in ERAS group from 21 days to 9 days. Results suggested less morbidity and less mortality but the difference was not statistically significant. There were significantly less severe complications ( grade 3 according to Dindo clavien classification) in ERAS group. Readmission rate in ERAS group was 13%. Conclusions: The implementation of ERAS in pancreatic surgery, in our center, was associated to high compliance, shorter length of hospital stay and less morbidity. Ongoing studies with larger population are necessary to confirm these results.