Skip to main page content
U.S. flag

An official website of the United States government

Dot gov

The .gov means it’s official.
Federal government websites often end in .gov or .mil. Before sharing sensitive information, make sure you’re on a federal government site.

Https

The site is secure.
The https:// ensures that you are connecting to the official website and that any information you provide is encrypted and transmitted securely.

Access keys NCBI Homepage MyNCBI Homepage Main Content Main Navigation
. 2023 Dec;47(12):2977-2989.
doi: 10.1007/s00268-023-07198-9. Epub 2023 Oct 3.

Global Perceptions on ERAS® in Pancreatoduodenectomy

Monish Karunakaran  1   2 , Didier Roulin  3 , Shahid Ullah  2 , Shailesh V Shrikhande  4   5 , Hans D De Boer  6 , Nicolas Demartines  7 , Savio George Barreto  8   9
Affiliations

Global Perceptions on ERAS® in Pancreatoduodenectomy

Monish Karunakaran et al. World J Surg. 2023 Dec.

Abstract

Background: Uptake of ERAS® pathways for pancreatic surgery have been slow and impacted by low compliance.

Objective: To explore global awareness, perceptions and practice of ERAS® peri-pancreatoduodenectomy (PD).

Methods: A structured, web-based survey (EPSILON) was administered through the ERAS® society and IHPBA membership.

Results: The 140 respondents included predominantly males (86.4%), from Europe (45%), practicing surgery (95%) at academic/teaching hospitals (63.6%) over a period of 10-20 years (38.6%). Most respondents identified themselves as general surgeons (68.6%) with 40.7% reporting an annual PD volume of 20-50 cases, practicing post-PD clinical pathways (37.9%), with 31.4% of respondents auditing their outcomes annually. Reduced medical complications, cost and hospital length of stay, and improved patient satisfaction were perceived benefits of compliance to enhancing-recovery. Multidisciplinary co-ordination was considered the most important factor in the implementation and sustainability of peri-PD ERAS® pathways, while reluctance to change among health care practitioners, difficulties in data collection and audit, lack of administrative support, and recruitment of an ERAS® dedicated nurse were reported to be important barriers.

Conclusions: The EPSILON survey highlighted global clinician perceptions regarding the benefits of compliance to peri-PD ERAS®, the importance of individual components, perceived facilitators and barriers, to the implementation and sustainability of these pathways.

PubMed Disclaimer

Conflict of interest statement

HDDB is a member of the global Advisory board of Merck, the Scientific Advisory Board of Senzime, the global Advisory Board of NMD Pharma, the Research Committee and Scientific (SI) Committee of the European Society of Anaesthesiology and Intensive Care and has received research grants from Merck and the Medicines Company.

Figures

Fig. 1
Fig. 1
a Radar plot (median score) and b Likert plot (%) demonstrating perceptions on benefits of compliance to peri-PD ERAS®
Fig. 2
Fig. 2
a Radar plot (median score) and b Likert plot (%) demonstrating participant perceptions on importance of individual components of peri-PD ERAS®
Fig. 3
Fig. 3
a Radar plot (median score) and b Likert plot (%) demonstrating participant perceptions on challenges to the application of individual ERAS® components
Fig. 4
Fig. 4
a Radar plot (median score) and b Likert plot (%) demonstrating participant perceptions on facilitators to implementation and sustainability of peri-PD ERAS® pathways
Fig. 5
Fig. 5
a Radar plot (median score) and b Likert plot (%) demonstrating participant perceptions on barriers to implementation and sustainability of peri-PD ERAS® pathways
Fig. 6
Fig. 6
Graphical summary of the findings of EPSILON
See this image and copyright information in PMC

References

    1. Ljungqvist O, Young-Fadok T, Demartines N. The history of enhanced recovery after surgery and the ERAS society. J Laparoendosc Adv Surg Tech A. 2017;27:860–862. doi: 10.1089/lap.2017.0350. - DOI - PubMed
    1. Ljungqvist O, Scott M, Fearon KC. Enhanced recovery after surgery: a review. JAMA Surg. 2017;152:292–298. doi: 10.1001/jamasurg.2016.4952. - DOI - PubMed
    1. Fearon KC, Ljungqvist O, Von Meyenfeldt M, et al. Enhanced recovery after surgery: a consensus review of clinical care for patients undergoing colonic resection. Clin Nutr. 2005;24:466–477. doi: 10.1016/j.clnu.2005.02.002. - DOI - PubMed
    1. Lassen K, Coolsen MM, Slim K, et al. Guidelines for perioperative care for pancreaticoduodenectomy: enhanced recovery after surgery (ERAS(R)) society recommendations. Clin Nutr. 2012;31:817–830. doi: 10.1016/j.clnu.2012.08.011. - DOI - PubMed
    1. Melloul E, Lassen K, Roulin D, et al. Guidelines for perioperative care for pancreatoduodenectomy: enhanced recovery after surgery (ERAS) recommendations 2019. World J Surg. 2020;44:2056–2084. doi: 10.1007/s00268-020-05462-w. - DOI - PubMed