Enhanced recovery after surgery in chronic pancreatitis

Abstract

Aim . To improve surgical outcomes in patients with chronic pancreatitis by means of enhanced recovery after surgery. Materials and methods. 112 patients with chronic pancreatitis underwent surgery over the past 5 years. Pancreatic head resection in different variants was performed in 78 patients (69.6%), and 34 patients (30.4%) underwent lateral pancreaticojejunostomy. All interventions were carried out through the midline laparotomy. Enhanced recovery after surgery was carried out for 48 patients (39.6%). The control group included 60 patients. Results. After pancreatic resection, patients in the main group were in the intensive care unit only on the day of surgery. As soon as the pancreaticojejunoanastomosis was formed, the patients were immediately transferred to the surgical department. Patients in the control group were in the intensive care unit for at least two days. Intestinal motility was revealed in patients of the main group on day 2, in the control group – on days 3–4. Four patients (7.7%) of the main group and 11 in the control group (18.3%) developed complications. No lethal outcomes were registered in the main group. One patient (1.7%) died in the control group. The average length of hospital stay comprised 9 ± 2.5 days in the main group and 15 ± 4.7 days in the control group ( p < 0.05). Conclusion . Enhanced recovery after surgery in patients with chronic pancreatitis reduces the number of postoperative complications, the duration of stay in the intensive care unit, the length of hospital stay and, therefore, improves immediate postoperative outcomes.