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 .
Effect of Mosapride on Recovery of Intestinal Motility After Hand-Assisted Laparoscopic Colectomy for Carcinoma
Purpose Mosapride citrate ( mosapride ) is a serotonin 5-hydroxytryptamine 4 receptor agonist known to promote gastric emptying and large-intestine motility . We assessed the effect of mosapride on postoperative ileus following colon surgery . Methods Forty patients with colon cancer undergoing h and -assisted laparoscopic colectomy were r and omly assigned to a mosapride group or a control group . The mosapride group received 15 mg of mosapride by mouth with 50 ml of water three times a day , starting on postoperative day 1 . The control group received 50 ml of water on the same schedule . Patients were allowed to resume oral feeding on the evening of postoperative day 2 . Postoperative time to first bowel movement was evaluated by one investigator blinded to treatment . Postoperative gastric emptying was evaluated with the [13C]-acetate breath test at 24 and 48 hours after the operation . Results Postoperative time to first bowel movement was significantly shorter in the mosapride group than in the control group ( 48.5 vs. 69.3 hours , P = 0.0149 ) . The time to maximal gastric emptying rate as determined by the breath test was significantly shorter in the mosapride group than in the control group at the 48-hour time point ( 27.9 vs. 35.3 minutes , P = 0.0294 ) . Postoperative hospital stay was shorter in patients receiving mosapride  than in controls ( 6.7 vs. 8.4 days , P = 0.0398 ) . No adverse effects were observed with mosapride . Conclusions Gastric emptying was improved by mosapride . The results suggested that the period of postoperative ileus following h and -assisted laparoscopic colectomy can be shortened by treatment with mosapride
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 .