Final Scholarly Project: Enhanced Recovery After Surgery (ERAS) Guidelines for Pancreaticoduodenectomies

A pancreaticoduodenectomy, or Whipple procedure, is the only curative option for pancreatic cancer. For those eligible for tumor resection, the Whipple procedure is a difficult surgery for both the patient and provider. Complications following pancreaticoduodenectomy are numerous and include infection, delayed gastric emptying, high hospital costs, and pancreatic fistulas. Enhanced Recovery After Surgery (ERAS) protocols exist to provide evidence supporting standardization of practices that lead to the improvement of these patient outcomes. An ERAS protocol for the pancreaticoduodenectomy, first established in 2012, is inconsistently implemented in healthcare facilities. Researchers collected data involving the use of the Whipple procedure ERAS guidelines in improving the following three outcomes: length of stay, incidence of incisional infection, and rates of delayed gastric emptying. After receiving approval from hospital administration, the project team will gather data from previous patients and educate staff members regarding the upcoming clinical practice change. A trial implementation period will last one year, or until 50 patients are enrolled. Following proper ERAS execution, investigators will again collect data and compare results in the three chosen outcomes. The project team expects that implementation will demonstrate an improved incidence rate of infection, delayed gastric emptying, and shorter length of stay following the pancreaticoduodenectomy. If the desired results are not realized, additional research will be necessary to investigate causative factors and ways to improve current practice.