[Experience of a cephalic pancreatoduodenectomy fast-track program].
BACKGROUND
Fast-track surgery has been proposed as a valid method in pancreatic surgery. Although morbidity and mortality has improved in the last decade, the prevalence of postoperative complications is still high. The aim of this study is to analyse the results of a programme of Fast-track surgery in this context.


RESULTS
A total of 82 patients who underwent a cephalic pancreatoduodenectomy with a programme of early recovery after surgery, were analysed. There were 53 men, with a median age of 63 years old. The median hospital stay was 9 days, with 14.6% of readmissions. The Clavien-DeOliveira Classification was applied to evaluate the severity of postoperative complications. The overall morbidity was 47.6%. The most common complications were general, followed by infection of surgical wound and cardiopulmonary events. Taking into account that a surgical drain was used in 32% of patients, the prevalence of pancreatic fistula was 8.5%, and were classified in the most severity grades (III, IV and V). The postoperative mortality was 4.9%. The associated surgery was a risk factor of mortality.


CONCLUSIONS
The Fast-track programme after pancreatoduodenectomy in high volume centres is a safe and effective method, that can improve the morbidty and mortality results.
Montiel Casado
María Custodia
MC
H.R.U. Carlos Haya, Málaga, Spain. custodiamc@yahoo.es
Pardo Sánchez
Fernando
F
Rotellar Sastre
Fernando
F
Martí Cruchaga
Pablo
P
Alvarez Cienfuegos
Francisco J
FJ
D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D005260:Female; D006801:Humans; D008297:Male; D008875:Middle Aged; D016577:Pancreaticoduodenectomy / Q000009:adverse effects / Q000379:methods*; D011183:Postoperative Complications / Q000453:epidemiology / Q000209:etiology; D012189:Retrospective Studies; D013997:Time Factors; D055815:Young Adult