title: [Application of enhanced recovery after surgery program in perioperative management of pancreaticoduodenectomy: a systematic review].
abstract: OBJECTIVE
  To conduct a systematic review of the safety and efficacy of enhanced recovery after surgery(ERAS) program in perioperative management of pancreaticoduodenectomy.
  
  
  METHODS
  A computerized search was performed in databases including PubMed, Embase, Medline, Web of Science, Cochrane Library, CNKI, Wanfang and VIP for randomized controlled trials (RCTs) or clinical controlled trials (CCTs) describing an ERAS program in patients undergoing pancreaticoduodenectomy published between January 1966 and May 2014. After assessment of methodological quality and data extraction, meta-analysis was performed using RevMan 5.2.0 software.
  
  
  RESULTS
  Six RCTs and 8 CCTs including 2565 patients were selected for this study, including the study group(n=1366) and the control group (n=1199). Compared with the control group, the study group had a shorter length of hospital stay(WMD=-3.67, 95% CI:-5.66--1.68, P<0.05), lower postoperative complication rate(OR=0.73, 95% CI:0.56-0.95, P<0.05) and lower mortality(OR=0.63, 95% CI:0.44-0.91, P<0.05). However, no significant differences existed in mortality, readmission rate and re-operation rate between the two groups.
  
  
  CONCLUSIONS
  Enhanced recovery after surgery programme in perioperative management of pancreaticoduodenectomy is safe and effective. But due to the medium quality of the literature. This still need more rigorously designed RCTs to prove the safety and efficiency of ERAS programme for the patients undergoing pancreaticoduodenectomy.
authors: Research Institute of General Surgery, Jinling Hospital, Nanjing Clinical School of Medicine, Southern Medical University, Nanjing 210002, China. wxinying@263.net.
authors: Qiucheng
authors: Q
authors: Lei
authors: Xinying
authors: X
authors: Wang
authors: Shanjun
authors: S
authors: Tan
authors: Xiao
authors: X
authors: Wan
authors: Huazhen
authors: H
authors: Zheng
authors: Ning
authors: N
authors: Li
mesh_terms: D006801:Humans; D007902:Length of Stay; D016577:Pancreaticoduodenectomy; D011183:Postoperative Complications