A well-implemented ERAS protocol with good compliance is associated with a reduction in medical complications and length of hospital stay .
Enhanced recovery after surgery ( ERAS ) pathways are now implemented worldwide with strong evidence that adhesion to such protocol reduces medical complications , costs and hospital stay .
This concept has been applied for pancreatic surgery since the first published guidelines in 2012 .
This study presents the up date d ERAS recommendations for  pancreatoduodenectomy ( PD )  based on the best available evidence and on expert consensus .
Forced-air warming and fluid warming minimize core hypothermia during abdominal surgery.
OBJECTIVE To evaluate the effect of intraoperative combined forced-air warming and fluid warming system on  patient 's core temperature , blood loss , transfusion dem and , extubation time , and incidence of postoperative shivering . METHODS Forty patients with American Society of Anesthesiologists physical status I and II , aged 18 - 70 years , scheduled for elective abdominal surgery were r and omly assigned to receive intraoperative warming from a forced-air blanket and fluid warming system or conventional cotton blanket , 20 in each group . The core temperature was recorded every 20 minutes during the operation , as well as the blood loss , blood transfusion , extubation time , and incidence of postoperative shivering . RESULTS The core temperature at the end of the surgery in the warming group was significantly different from that in the control group ( 36.4 + /- 0.4 degrees C vs. 35.3 + /- 0.5 degrees C , P < 0.001 ) . Application of intraoperative warming significantly shortened the time between the end of the surgery and extubation ( P < 0.01 ) . Postoperative shivering occurred in 30 % of the patients in the control group compared to no patient in the warming group ( P < 0.01 ) . CONCLUSION Active warming with air-forced blanket and fluid warming system provides sufficient heat to prevent hypothermia during abdominal surgery
A well-implemented ERAS protocol with good compliance is associated with a reduction in medical complications and length of hospital stay .
Enhanced recovery after surgery ( ERAS ) pathways are now implemented worldwide with strong evidence that adhesion to such protocol reduces medical complications , costs and hospital stay .
This concept has been applied for pancreatic surgery since the first published guidelines in 2012 .
This study presents the up date d ERAS recommendations for  pancreatoduodenectomy ( PD )  based on the best available evidence and on expert consensus .