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 .
Prospectively Randomized Trial Using Perioperative Low Dose Octreotide to Prevent Organ Related and General Complications Following Pancreatic Surgery and Pancreatico-jejunostomy
Abstract Background : The aim of the study was to evaluate the influence of low dose perioperative Octreotide on the prevention of complications ( pancreatic fistula and general complications ) in patients undergoing pancreatic surgery followed by pancreatico-jejunostomy . Material and Methods : 105 patients were r and omized to receive either Octreotide 0.1 mg subcutaneously 3 times/day for a total of 7 days or no Octreotide . The primary endpoints were the occurrence of a pancreatic fistula and /or general complications including the length of hospital stay . There were 25 surgical draining procedures performed and 80 duodeno-pancreatectomies with or without preservation of the pylorus . Twenty-six ( 24.8 % ) of the patiënts were treated for chronic pancreatitis , 8 ( 7.6 % ) for benign tumoral disease and 71 ( 67.6 % ) for carcinoma . All patients underwent pancreatico-jejunostomy . Results : 56 patients received Octreotide and 49 did not . The incidence of fistula formation in the Octreotide group was 8.9 % ( n = 5 ) and in the control group 8.2 % ( n = 4 ) for a total incidence of 8.5 % . The difference between the two groups was not statistically significant . There was one death in the Octreotide group and none in the control group for an overall mortality of 0.9 % . The morbidity , except fistulas , was 10.7 % in the Octreotide group and 12.2 % in the control group . The length of hospital stay was 23.1 ± 15.1 days in the group receiving Octreotide vs 20.4 ± 8.1 days in the control group ( p = 0.808 ) . Stratifying the data for duodenopancreatectomy and for draining procedures there was no difference between the groups either . Conclusion : In patients undergoing pancreatic surgery and pancreatico-jejunostomy , the perioperative use of 3 χ 0.1 mg Octreotide for 7 days does not reduce general complications nor fistula formation
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 .