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 .
Comparative analysis of the efficacy and complications of nasojejunal and jejunostomy on patients undergoing pancreaticoduodenectomy.
BACKGROUND The efficacy and feeding-related complications of a nasojejunal feeding tube and jejunostomy after pancreaticoduodenectomy ( PD ) was investigated with a r and omized , controlled clinical trial at the Affiliated Drum Tower Hospital . METHODS Sixty-eight patients who underwent PD in the Department of Hepatobiliary Surgery were r and omly divided into 2 groups : 34 patients received enteral feeding via a nasojejunal tube ( NJT group ) and 34 patients received enteral feeding via a jejunostomy tube ( JT group ) . The assessment of clinical outcome was based on postoperative investigation of complications . The second part of the assessment included tube related complications and an index on catheter efficiency . RESULTS There were 15 cases with infectious complications in the JT group and 13 cases in the NJT group , and there was no significant difference in the rate of infectious complications between the 2 groups . The rate of intestinal obstruction and delayed gastric emptying was significantly decreased in the NJT group ( P < .05 ) . Catheter-related complications were more common in the JT group as compared with the NJT group ( 35.3 % vs 20.6 % , P < .05 ) . The time for removal of the feeding tube and nasogastric tube was significantly decreased in the NJT group . The postoperative hospital stay in the NJT group was significantly decreased ( P < .05 ) , and there was no hospital mortality in this study . CONCLUSION Nasojejunal feeding is safer than jejunostomy , and it is associated with only minor complications . Nasojejunal feeding can significantly decrease the incidence of delayed gastric emptying and shorten the postoperative hospital stay
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 .