Influence of an enhanced recovery programme on clinical outcomes and health-related quality of life after pancreaticoduodenectomy ad modum Whipple – an explorative and comparative single-centre study

Abstract Background The introduction of enhanced recovery programmes (ERP) in pancreatic surgery has significantly improved clinical outcomes by decreasing the length of hospital stay, cost and complications without increasing readmissions and reoperations. To complement evidence on these outcomes,...

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Main Authors: Thomas Andersson, My Engström, Johanna Wennerblom, Hanna Gyllensten, Kristofer Bjerså
Format: Article
Language:English
Published: BMC 2024-12-01
Series:BMC Surgery
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Online Access:https://doi.org/10.1186/s12893-024-02667-x
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author Thomas Andersson
My Engström
Johanna Wennerblom
Hanna Gyllensten
Kristofer Bjerså
author_facet Thomas Andersson
My Engström
Johanna Wennerblom
Hanna Gyllensten
Kristofer Bjerså
author_sort Thomas Andersson
collection DOAJ
description Abstract Background The introduction of enhanced recovery programmes (ERP) in pancreatic surgery has significantly improved clinical outcomes by decreasing the length of hospital stay, cost and complications without increasing readmissions and reoperations. To complement evidence on these outcomes, there is a need to explore patients’ perspectives of a structured ERP. Therefore, this study aimed to explore the health-related quality of life (HRQoL) of patients before and after implementing ERP in pancreaticoduodenectomy ad modum Whipple (PD) at a regional surgical centre. Method This was an explorative and comparative single-centre study in Sweden. A prospective cohort receiving ERP was included between October 2019 and December 2022 (n = 73) and was compared with a retrospective pre-ERP cohort between October 2011 and December 2013 (n = 65). EQ-5D, the European Organization for Research and Treatment of Cancer (EORCT) Quality of Life Questionnaire Cancer 30 items (QOL-C30), and EORCT Quality of Life Questionnaire pancreatic cancer module (QOL-PAN26) were collected preoperatively and at three and six months postoperatively. Demographic and clinical variables were collected from patient charts. Complications were expressed using the Clavien-Dindo Classification and the Comprehensive Complications Index (CCI). Results There were no significant differences in general health, cancer- or disease-specific HRQoL between the pre-ERP and ERP cohorts. Length of stay was significantly shorter in the ERP cohort (16 vs. 11 days; p < 0.001). There was no significant difference in CCI. Conclusion No significant differences were found in the HRQoL of patients who participated in an ERP compared to those who did not. However, a significant decrease in LoS was found when ERP was applied. Trial registration Not applicable.
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spelling doaj-art-d89dea9a2ed943189d1a80fb48b583d52025-08-20T02:31:51ZengBMCBMC Surgery1471-24822024-12-0124111810.1186/s12893-024-02667-xInfluence of an enhanced recovery programme on clinical outcomes and health-related quality of life after pancreaticoduodenectomy ad modum Whipple – an explorative and comparative single-centre studyThomas Andersson0My Engström1Johanna Wennerblom2Hanna Gyllensten3Kristofer Bjerså4Department of Surgery, Institute of Clinical Sciences, Sahlgrenska Academy, University of GothenburgRegion Västra Göteland, Department of Surgery, Sahlgrenska University HospitalDepartment of Surgery, Institute of Clinical Sciences, Sahlgrenska Academy, University of GothenburgInstitute of Health and Care Sciences, Sahlgrenska Academy University of GothenburgDepartment of Surgery, Institute of Clinical Sciences, Sahlgrenska Academy, University of GothenburgAbstract Background The introduction of enhanced recovery programmes (ERP) in pancreatic surgery has significantly improved clinical outcomes by decreasing the length of hospital stay, cost and complications without increasing readmissions and reoperations. To complement evidence on these outcomes, there is a need to explore patients’ perspectives of a structured ERP. Therefore, this study aimed to explore the health-related quality of life (HRQoL) of patients before and after implementing ERP in pancreaticoduodenectomy ad modum Whipple (PD) at a regional surgical centre. Method This was an explorative and comparative single-centre study in Sweden. A prospective cohort receiving ERP was included between October 2019 and December 2022 (n = 73) and was compared with a retrospective pre-ERP cohort between October 2011 and December 2013 (n = 65). EQ-5D, the European Organization for Research and Treatment of Cancer (EORCT) Quality of Life Questionnaire Cancer 30 items (QOL-C30), and EORCT Quality of Life Questionnaire pancreatic cancer module (QOL-PAN26) were collected preoperatively and at three and six months postoperatively. Demographic and clinical variables were collected from patient charts. Complications were expressed using the Clavien-Dindo Classification and the Comprehensive Complications Index (CCI). Results There were no significant differences in general health, cancer- or disease-specific HRQoL between the pre-ERP and ERP cohorts. Length of stay was significantly shorter in the ERP cohort (16 vs. 11 days; p < 0.001). There was no significant difference in CCI. Conclusion No significant differences were found in the HRQoL of patients who participated in an ERP compared to those who did not. However, a significant decrease in LoS was found when ERP was applied. Trial registration Not applicable.https://doi.org/10.1186/s12893-024-02667-xEnhanced recovery programPancreatic surgeryHealth related quality of life
spellingShingle Thomas Andersson
My Engström
Johanna Wennerblom
Hanna Gyllensten
Kristofer Bjerså
Influence of an enhanced recovery programme on clinical outcomes and health-related quality of life after pancreaticoduodenectomy ad modum Whipple – an explorative and comparative single-centre study
BMC Surgery
Enhanced recovery program
Pancreatic surgery
Health related quality of life
title Influence of an enhanced recovery programme on clinical outcomes and health-related quality of life after pancreaticoduodenectomy ad modum Whipple – an explorative and comparative single-centre study
title_full Influence of an enhanced recovery programme on clinical outcomes and health-related quality of life after pancreaticoduodenectomy ad modum Whipple – an explorative and comparative single-centre study
title_fullStr Influence of an enhanced recovery programme on clinical outcomes and health-related quality of life after pancreaticoduodenectomy ad modum Whipple – an explorative and comparative single-centre study
title_full_unstemmed Influence of an enhanced recovery programme on clinical outcomes and health-related quality of life after pancreaticoduodenectomy ad modum Whipple – an explorative and comparative single-centre study
title_short Influence of an enhanced recovery programme on clinical outcomes and health-related quality of life after pancreaticoduodenectomy ad modum Whipple – an explorative and comparative single-centre study
title_sort influence of an enhanced recovery programme on clinical outcomes and health related quality of life after pancreaticoduodenectomy ad modum whipple an explorative and comparative single centre study
topic Enhanced recovery program
Pancreatic surgery
Health related quality of life
url https://doi.org/10.1186/s12893-024-02667-x
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