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 polylactic film (Surgi-Wrap) on preventing postoperative ileus after major hepato-pancreato-biliary surgery
Background s/ Aims Major hepato-pancreato-biliary ( HPB ) surgery is usually performed via an open method rather than a laparoscopic method . Postoperative ileus ( POI ) is a classic complication after open surgery . The purpose of this study was to determine whether polylactic film is useful in the prevention of POI . Methods A total of 179 patients who underwent major HPB surgery between 2005 and 2014 , were retrospectively review ed . A diagnosis of POI was made by a physical examination , laboratory , and radiological findings . Surgi-Wrap ® polylactic film was preferentially used intraperitoneally by surgeons , just before wound closure . Results Major HPB surgery included pancreatoduodenectomy ( n=48 ) , distal or subtotal pancreatectomy ( n=24 ) , hepatectomy ( n=67 ) , other bile duct or gallbladder operations ( n=35 ) , and others ( n=5 ) . Although patients with polylactic film showed a significantly lower incidence of POI ( n=3 , 4.1 % vs. n=14 , 13.3 % , p=0.041 ) , they showed a significantly higher complication rate ( n=20 , 27.0 % vs. n=19 , 18.1 % , p=0.004 ) , particularly intra-abdominal fluid collection ( n=7 , 9.4 % vs. n=2 , 1.9 % ) , and wound infections ( n=6 , 8.1 % vs. n=3 , 2.9 % ) , than those who did not receive the film , respectively . Conclusions Although the polylactic film  prevented POI , more complications other than POI were observed . Well- design ed r and omized controlled trials , using this anti-adhesive product , are needed to evaluate its effect on POI after major HPB 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 .