Efficacy of a Fast-Track Recovery Programme after Pancreatoduodenectomy

Introduction: The fast-track (FT) postoperative protocol was developed to improve the postoperative care of patients, through early mobilization and diet resumption, reducing the length of postoperative stay in hospital. Aim: Evaluation of the FT recovery protocol after major liver resection aimed at decreasing peri-operative morbidity and the length of hospitalization after major liver surgery. Method: Between January 2012 and December 2013, 62 consecutive patients suffering from malignant liver tumour treated surgically were prospectively divided randomly into two groups: Group A (n=32) followed the FT recovery protocol and Group B (n=30) were treated with the conventional protocol (CON). Postoperative morbidity, readmission rate, and median hospital stay were compared in the two groups. Results: The FT protocol was associated with a lower complication rate (p=0.119) and the risk of postoperative morbidity was 3.37 times higher in patients treated with the CON protocol (p=0.119). The readmission rate was not significantly different between the two groups (p=0.062). The age (p=0.068) and body mass index (BMI) (p=0.336) were not factors contraindicating the FT protocol. The mean length of postoperative stay was 6.5±2.44 days in the FT group and 11.44±4.42 days in the CON group (p<0.001). Conclusions: The FT recovery protocol appears to be safe and particularly efficacious in patients undergoing major liver resection.