Impact of Fast-Track Concept Elements in the Classical Pancreatic Head Resection (Kausch-Whipple Procedure)

• Authors: Ingo Gastinger , Frank Meyer , Thomas Lembcke , Uwe Schmidt , Henry Ptok , Hans Lippert
• Languages of publication: EN

Abstracts

EN

The aim of the study was to determine statistically significant factors with an impact on the early postoperative surgical outcome.Material and methods. The influence of applied fast-track components on surgical results and early postoperative outcome in 143 consecutive Kausch-Whipple procedure patients was evaluated in a single-center retrospective analysis of a prospective collection of patient-associated pre-, peri- and postoperative data from 1997-2006.Results. The in-hospital mortality rate was 2.8% (n=4). Fast-track measures were shown to have no effect on the morbidity rate in the multi-variate analysis. Over the study period, a decrease of intraoperative infusion volume from 14.2 mL/kg body weight/h in the first year to 10.7 mL/kg body weight/h in the last year was accompanied by an increase in patients requiring intraoperative catecholamines, up from 17% to 95%. The administration of ropivacain/sufentanil via thoracic peri-dural catheter injection initiated in 2000 and now considered the leading analgesic method, was used in 95% of the cases in 2006. Early extubation rate rose from 16.6% to 57.9%.Conclusions. Fast-track aspects in the perioperative management have become more important in several surgical procedure even in those with a greater invasiveness such as Kausch-Whipple. However, such techniques used in peri-operative management of Kausch-Whipple pancreatic-head resections had no impact on the morbidity rate. In addition, the low in-hospital mortality rate was particularly attributed to surgical competence.

Keywords

EN

Kausch-Whipple pancreaticoduodenectomy; perioperative management; fast-track concepts; surgical results; early postoperative outcome

• Publisher: De Gruyter Open
• Journal: Polish Journal of Surgery
• Year: 2012
• Volume: 84
• Issue: 8
• Pages: 390-398

Dates

published

1 - 8 - 2012

online

17 - 9 - 2012

Contributors

author

Ingo Gastinger

• Institute for Quality Assurance in Medicine, Magdeburg, University Hospital

author

Frank Meyer

• Department of General, Abdominal and Vascular Surgery, University Hospital in Magdeburg

author

Thomas Lembcke

• Department of Anesthesiology, Intensive Care and Palliative Medicine, Carl-Thiem Hospital in Cottbus

author

Uwe Schmidt

• Stat Consult, Magdeburg

author

Henry Ptok

• Department of Surgery, Carl-Thiem Hospital Cottbus, Cottbus

author

Hans Lippert

• Department of General, Abdominal and Vascular Surgery, University Hospital in Magdeburg

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Identifiers

DOI

10.2478/v10035-012-0066-4