title: The role of fast-track surgery in pancreaticoduodenectomy: a retrospective cohort study of 635 consecutive resections.
abstract: BACKGROUND
  Pancreaticoduodenectomy (PD) is one of the most difficult and dangerous operations in general surgery. This study used the concept of fast-track surgery (FTS) technique, which involves pain control, early enteral nutrition and other measures during the preoperative period, to evaluate the rate of complications and shorter hospitalization.
  
  
  METHODS
  This retrospective, observational study was conducted between January 2009 and January 2013. A total of 635 patients underwent PD in the Department of Pancreatic Surgery at ChangHai Hospital (Shanghai, China). 325 patients had FTS and 310 patients received the traditional pathway of treatment. The incidence of postoperative complications, the serum albumin level, expenses, postoperative hospitalization, and readmission rates were compared.
  
  
  RESULTS
  There were no significant differences in the blood transfusion volume, nasogastric intubation, and readmission rates (p > 0.05). However, the FTS group had less postoperative hospitalization, fewer expenses and a lower incidence of postoperative complications compared with the control group (p<0.05).
  
  
  CONCLUSIONS
  Pancreaticoduodenectomy can be further optimized by the use of FTS methods, which can reduce the incidence of in hospital postoperative complications and expenses without increasing the risk of readmission.
authors.affiliation: Department of General Surgery, ChangHai Hospital, Shanghai, China. Electronic address: szlaugh@163.com.
authors.forename: Zhuo
authors.initials: Z
authors.lastname: Shao
authors.affiliation: Department of General Surgery, ChangHai Hospital, Shanghai, China. Electronic address: smmujg@163.com.
authors.forename: Gang
authors.initials: G
authors.lastname: Jin
authors.affiliation: Department of General Surgery, ChangHai Hospital, Shanghai, China. Electronic address: smmujwp@163.com.
authors.forename: Weiping
authors.initials: W
authors.lastname: Ji
authors.affiliation: Department of General Surgery, ChangHai Hospital, Shanghai, China. Electronic address: smmusl@163.com.
authors.forename: Li
authors.initials: L
authors.lastname: Shen
authors.affiliation: Department of General Surgery, ChangHai Hospital, Shanghai, China. Electronic address: huxiangui@yeah.net.
authors.forename: Xiangui
authors.initials: X
authors.lastname: Hu
mesh_terms: D004750:Enteral Nutrition; D006801:Humans; D016577:Pancreaticoduodenectomy / Q000009:adverse effects*; D011182:Postoperative Care; D011183:Postoperative Complications / Q000517:prevention & control; D011300:Preoperative Care; D012189:Retrospective Studies; D013997:Time Factors
keywords: Enteral nutrition; Fast-track surgery; Pancreaticoduodenectomy