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 .
The Impact of Preoperative Enteral Nutrition Enriched with Eicosapentaenoic Acid on Postoperative Hypercytokinemia after Pancreatoduodenectomy: The Results of a Double-Blinded Randomized Controlled Trial
Aims : To investigate whether preoperative enteral diets enriched in eicosapentaenoic acid ( EPA ) supplements could reduce the incidence of hypercytokinemia after pancreatoduodenectomy ( PD ) in a double-blinded r and omized controlled trial . Methods : Patients with resectable periampullary cancer were r and omized into either the control group or the treatment group . Patients in the treatment group received oral supplementation ( 600 kcal/day ) containing EPA for 7 days before surgery . Patients in the control group received isocaloric isonitrogenous st and ard nutrition ( 600 kcal/day ) without EPA for 7 days before surgery . The primary endpoint was postoperative serum concentrations of interleukin-6 ( IL-6 ) . The secondary endpoints were the postoperative nutritional status and the incidence of postoperative infectious complications . Results : Twenty-four patients were enrolled in the present study . After exclusion , 20 patients ( control group , n = 9 ; treatment group , n = 11 ) were analyzed . There were no significant differences in the curves for the serum concentration of IL-6 ( p = 0.68 ) or the incidence of infectious complications between the 2 groups ( control group : 78 % , treatment group : 55 % , p = 0.37 ) . Conclusions : The results of a double-blinded r and omized controlled trial indicated that preoperative immunonutrition had no marked impact on the rates of postoperative hypercytokinemia or infectious complications after PD
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 .