(O P1) Analysis of ERAS Protocol in Patients Undergoing Pancreaticoduodenectomy

Intro Enhanced recovery after surgery (ERAS) protocols have been designed to shorten hospital stays and standardize peri-operative care. Our aim was to study ERAS protocols in patients undergoing pancreaticoduodenectomy (Whipple). Methods We analyzed who had undergone a Whipple between 2012 and 2019 at Wake Forest. Patients were excluded if the operation was aborted. Final analysis employed a Wilcoxon Two-Sample test and Fisher’s Exact tests for analysis between ERAS and non-ERAS groups. Results Eighty-six patients were identified to be included in the analysis, with 55 in the non-ERAS pathway and 31 in the ERAS pathway. There was no statistical difference between the two groups regarding baseline demographics and comorbidities. There was a significant difference amongst the two groups when we analyzed those who had received regional anesthesia (p < 0.0001), specifically TAP blocks. The type of Whipple (pylorus-preserving or classic) had no impact on outcomes, p > 0.99. number of complications was also significantly greater in the non-ERAS group (p = 0.02) but did not impact length of stay for ERAS and non-ERAS groups, 8.0 days and 9.0 days respectively (p = 0.3). There was no difference in time to adjuvant chemotherapy, measured as days from operation, between the ERAS and non-ERAS groups (58 days vs. 56 days, p = 0.64). Discussion Our study did not find a measurable statistical significance in time to adjuvant therapy for ERAS and non-ERAS patients. ERAS patients did suffered fewer complications but did not benefit from significantly decreased length in stay.