Improved Outcomes in 394 Pancreatic Cancer Resections: the Impact of Enhanced Recovery Pathway

Background Enhanced recovery (ER) pathway reduces morbidity and accelerates recovery. It is associated with reduced postoperative stay, morbidity, and costs. Feasibility and safety of ER programme has not been studied in developing countries. The objectives were to assess compliance with Enhanced Recovery After Surgery (ERAS) elements and to assess outcomes in pancreatic surgery. Methods Prospective study conducted from February 2014 to December 2016, following elective pancreatic cancer surgery. Team was educated prior to implementation of ERAS. Patients were followed up until 30 days postoperatively or discharge. Data was recorded regarding the compliance with the protocol, functional GI recovery, mobilisation, and postoperative morbidity and mortality. Results A total of 394 patients underwent surgery. Compliance with ER elements implemented was 84% (23–100%). Compliance > 80% with ER elements was observed in 278 patients (70.5%) and 80% compliance have significantly lower major complications (28.7 vs. 44%, p = 0.001), mortality (2.1 vs. 6.8%, p = 0.021), and postoperative stay (11 (5–78) days vs. 15 (4–61) days, p