Trial reportWorld journal of surgery2015
Implementation of an Enhanced Recovery Pathway After Pancreaticoduodenectomy in Patients with Low Drain Fluid Amylase.
Trial report in World journal of surgery, 2015. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 15 papers, 6 of them syntheses that pooled it.
What it found
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The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.
The trial behind it
Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.
Neither the registry nor the abstract names a trial number. If this is a trial report, that itself is worth knowing.
Who cites it
15 citing papers in PubMed, 6 syntheses or guidelines pooled it, 50 citations in OpenAlex.
- Use and management of routine prophylactic abdominal drainage in pancreatic surgery: meta-analysis of randomized clinical trials.BJS open · 2025Pooled it
- Costs and clinical benefits of enhanced recovery after surgery (ERAS) in pancreaticoduodenectomy: an updated systematic review and meta-analysis.Journal of cancer research and clinical oncology · 2023Pooled it
- Pooled it
- The Safety and Feasibility of Enhanced Recovery after Surgery in Patients Undergoing Pancreaticoduodenectomy: An Updated Meta-Analysis.BioMed research international · 2020Pooled it
- Amylase in drain fluid for the diagnosis of pancreatic leak in post-pancreatic resection.The Cochrane database of systematic reviews · 2017Pooled it
- Pooled it
- A systematic review of methodology in nutritional trials in patients undergoing pancreatoduodenectomy.Hepatobiliary surgery and nutrition · 2026Review
- Potential clinical utility of intraoperative fluid amylase measurement during pancreaticoduodenectomy.Annals of hepato-biliary-pancreatic surgery · 2023Article
- Iterative Changes in Risk-Stratified Pancreatectomy Clinical Pathways and Accelerated Discharge After Pancreaticoduodenectomy.Journal of gastrointestinal surgery : official journal of the Society for Surgery of the Alimentary Tract · 2022Article
- Multidisciplinary consensus statement on the clinical management of patients with pancreatic cancer.Clinical & translational oncology : official publication of the Federation of Spanish Oncology Societies and of the National Cancer Institute of Mexico · 2020Article
- Evidence for enhanced recovery in pancreatic cancer surgery.Langenbeck's archives of surgery · 2020Review
- Integrating perioperative medicine with anaesthesia in India: Can the best be achieved? A review.Indian journal of anaesthesia · 2019Review
- Standardization of early drain removal following pancreatic resection: proposal of the "Ottawa pancreatic drain algorithm".Patient safety in surgery · 2019Article
- Implementation and Evaluation of a Clinical Pathway for Pancreaticoduodenectomy Procedures: a Prospective Cohort Study.Journal of gastrointestinal surgery : official journal of the Society for Surgery of the Alimentary Tract · 2017Article
- Enhanced recovery pathways in pancreatic surgery: State of the art.World journal of gastroenterology · 2016Review
Corrections and comments
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Authors and funding
7 authors at 2 institutions in 1 country.
Funding
No grant is acknowledged in the PubMed record.
Abstract
introductionThe safety and feasibility of an enhanced recovery pathway (ERP) after pancreatic surgery is largely unknown. Our aim was to prospectively evaluate a targeted ERP after pancreaticoduodenectomy (PD), using first postoperative day (POD) drain fluid amylase (DFA1) values to identify patients at low risk of pancreatic fistula (PF). PATIENTS AND
methodsNon-randomized cohort study of 130 consecutive patients. Perioperative outcomes were compared before (pre-ERP; N=65) and after (post-ERP; N=65) implementation of an ERP. Patients in each group were stratified according to the risk of PF using DFA1<350 IU/l. Low-risk patients in the post-ERP group were selected for early oral intake and early drain removal.
results81/130 patients had a DFA1<350. Incidence of PF was significantly lower in low-risk patients (9 vs. 45%, P=0.0001). In low-risk patients, morbidity (43 vs. 36%) and mortality (2.7 vs. 4.5%) were similar for both pre- and post-ERP patients. Hospital stay (median 9 vs. 7 days, P=0.03) and 30-day readmissions (17 vs. 2%, P=0.04) were lower in low-risk patients in the post-ERP group. In high-risk patients, there was no difference in outcomes between pre- and post-ERP.
conclusionPatients at low risk of PF after PD can be identified by first POD DFA1. Enhanced recovery after PD is safe and leads to improved short-term outcomes in low-risk patients.
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