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 effect of early mobilization protocols on postoperative outcomes following abdominal and thoracic surgery: A systematic review.
BACKGROUND Early mobilization is considered an important element of postoperative care ; however , how best to implement this intervention in clinical practice is unknown . This systematic review summarizes the evidence regarding the impact of specific early mobilization protocol s on postoperative outcomes after abdominal and thoracic surgery . METHOD The review was performed according to PRISMA guidelines . We search ed 8 electronic data bases to identify studies comparing patients receiving a specific protocol of early mobilization to a control group .  Method ologic quality was assessed using the Downs and Black tool . RESULTS Four studies in abdominal surgery ( 3 r and omized controlled trials [ RCTs ] and 1 observational prospect i ve study ) and 4 studies in thoracic surgery ( 3 RCTs and 1 observational retrospective study ) were identified . None of the 5 studies evaluating postoperative complications reported differences between groups . One of 4 studies evaluating duration of stay reported a significant decrease in the intervention group . One of 3 studies evaluating gastrointestinal function reported differences in favor of the intervention group . One of 4 studies evaluating performance-based outcomes reported differences in favor of the intervention group . One of 5 studies evaluating patient-reported outcomes reported differences in favor of the intervention group . Overall method ologic quality was poor . CONCLUSION Few comparative studies have evaluated the impact of early mobilization protocol s on outcomes after abdominal and thoracic surgery . The quality of these studies was poor and results were conflicting . Although bed rest is harmful , there is little available evidence to guide clinicians in effective early mobilization protocol s that increase mobilization and improve outcomes
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 .