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Fast-track programmes for hepatopancreatic resections: where do we stand?

Spelt, Lidewij LU ; Ansari, Daniel LU ; Sturesson, Christian LU ; Tingstedt, Bobby LU and Andersson, Roland LU (2011) In HPB 13(12). p.833-838
Abstract
Background: Fast-track (FT) programmes represent a series of multimodal concepts that may reduce surgical stress and speed up convalescence after surgery. The aim of this systematic review was to evaluate FT programmes for patients undergoing hepatopancreatic surgery. Methods: PubMed, Embase and the Cochrane Library databases were searched for studies of FT vs. conventional recovery strategies for liver and pancreatic resections. Results: For liver surgery, three cohort studies were included. Primary hospital stay was significantly reduced after FT care in two of the three studies. There were no significant differences in rates of readmission, morbidity and mortality. For pancreatic surgery, three cohort studies and one case-control study... (More)
Background: Fast-track (FT) programmes represent a series of multimodal concepts that may reduce surgical stress and speed up convalescence after surgery. The aim of this systematic review was to evaluate FT programmes for patients undergoing hepatopancreatic surgery. Methods: PubMed, Embase and the Cochrane Library databases were searched for studies of FT vs. conventional recovery strategies for liver and pancreatic resections. Results: For liver surgery, three cohort studies were included. Primary hospital stay was significantly reduced after FT care in two of the three studies. There were no significant differences in rates of readmission, morbidity and mortality. For pancreatic surgery, three cohort studies and one case-control study were included. Primary hospital stay was significantly shorter after FT care in three out of the four studies. One study reported a significantly decreased readmission rate (7% vs. 25%; P= 0.027), and another study showed lower morbidity (47.2% vs. 58.7%; P < 0.01) in favour of the FT group. There was no difference in mortality between the FT and control groups. Conclusions: FT rehabilitation for liver and pancreatic surgical patients is feasible. Future investigation should focus on optimizing individual elements of the FT programme within the context of liver and pancreatic surgery. (Less)
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author
organization
publishing date
type
Contribution to journal
publication status
published
subject
in
HPB
volume
13
issue
12
pages
833 - 838
publisher
Informa Healthcare
external identifiers
  • wos:000297051400002
  • pmid:22081917
  • scopus:81255171431
ISSN
1477-2574
DOI
10.1111/j.1477-2574.2011.00391.x
language
English
LU publication?
yes
id
0e3fe0ea-0a18-4cc5-806b-d99e3161f352 (old id 2220773)
alternative location
http://www.ncbi.nlm.nih.gov/pubmed/22081917?dopt=Abstract
date added to LUP
2011-12-02 21:40:43
date last changed
2017-08-27 05:46:34
@article{0e3fe0ea-0a18-4cc5-806b-d99e3161f352,
  abstract     = {Background: Fast-track (FT) programmes represent a series of multimodal concepts that may reduce surgical stress and speed up convalescence after surgery. The aim of this systematic review was to evaluate FT programmes for patients undergoing hepatopancreatic surgery. Methods: PubMed, Embase and the Cochrane Library databases were searched for studies of FT vs. conventional recovery strategies for liver and pancreatic resections. Results: For liver surgery, three cohort studies were included. Primary hospital stay was significantly reduced after FT care in two of the three studies. There were no significant differences in rates of readmission, morbidity and mortality. For pancreatic surgery, three cohort studies and one case-control study were included. Primary hospital stay was significantly shorter after FT care in three out of the four studies. One study reported a significantly decreased readmission rate (7% vs. 25%; P= 0.027), and another study showed lower morbidity (47.2% vs. 58.7%; P &lt; 0.01) in favour of the FT group. There was no difference in mortality between the FT and control groups. Conclusions: FT rehabilitation for liver and pancreatic surgical patients is feasible. Future investigation should focus on optimizing individual elements of the FT programme within the context of liver and pancreatic surgery.},
  author       = {Spelt, Lidewij and Ansari, Daniel and Sturesson, Christian and Tingstedt, Bobby and Andersson, Roland},
  issn         = {1477-2574},
  language     = {eng},
  number       = {12},
  pages        = {833--838},
  publisher    = {Informa Healthcare},
  series       = {HPB},
  title        = {Fast-track programmes for hepatopancreatic resections: where do we stand?},
  url          = {http://dx.doi.org/10.1111/j.1477-2574.2011.00391.x},
  volume       = {13},
  year         = {2011},
}