A Modified Enhanced Recovery Pathway after Pancreaticoduodenectomy: Full Liquids on Discharge

Background: After success in many surgical disciplines, enhanced recovery after surgery pathways have been recently introduced to the care of patients after pancreatic surgery. The aim of this study is to share our improved outcomes with a modified pathway that allows patients to be discharged home on a full liquid diet. Methods: A modified enhanced recovery pathway was based on published guidelines but included new changes aiming to improve outcomes after pancreaticoduodenectomy in a total of 60 consecutive patients. Results: Patients included in this study had no significant differences in demographics and preoperative characteristics. By implementing a modified enhanced recovery protocol, we were able to improve post-operative parameters, including a decrease in the length of stay to a median of 5 days. Compliance rate with the program reached 88% and patients were able to maintain a similar weight compared to the regular pathway at 30 days. Time to adjuvant therapy was reduced without significantly increasing overall complications or readmission rates. Conclusion: A modified enhanced recovery pathway after pancreaticoduodenectomy successfully improved short-term outcomes and reduced hospital stay.