%0 Journal Article
%T Impact of Fast-Track Concept Elements in the Classical Pancreatic Head Resection (Kausch-Whipple Procedure)
%A Ingo Gastinger
%A Frank Meyer
%A Thomas Lembcke
%A Uwe Schmidt
%A Henry Ptok
%A Hans Lippert
%J Polish Journal of Surgery
%D 2012
%I Versita
%R 10.2478/v10035-012-0066-4
%X The aim of the study was to determine statistically significant factors with an impact on the early postoperative surgical outcome. Material and methods. The influence of applied fast-track components on surgical results and early postoperative outcome in 143 consecutive Kausch-Whipple procedure patients was evaluated in a single-center retrospective analysis of a prospective collection of patient-associated pre-, peri- and postoperative data from 1997-2006. Results. The in-hospital mortality rate was 2.8% (n=4). Fast-track measures were shown to have no effect on the morbidity rate in the multi-variate analysis. Over the study period, a decrease of intraoperative infusion volume from 14.2 mL/kg body weight/h in the first year to 10.7 mL/kg body weight/h in the last year was accompanied by an increase in patients requiring intraoperative catecholamines, up from 17% to 95%. The administration of ropivacain/sufentanil via thoracic peri-dural catheter injection initiated in 2000 and now considered the leading analgesic method, was used in 95% of the cases in 2006. Early extubation rate rose from 16.6% to 57.9%. Conclusions. Fast-track aspects in the perioperative management have become more important in several surgical procedure even in those with a greater invasiveness such as Kausch-Whipple. However, such techniques used in peri-operative management of Kausch-Whipple pancreatic-head resections had no impact on the morbidity rate. In addition, the low in-hospital mortality rate was particularly attributed to surgical competence.
%K Kausch-Whipple pancreaticoduodenectomy
%K perioperative management
%K fast-track concepts
%K surgical results
%K early postoperative outcome
%U http://versita.metapress.com/content/011g7267r3686555/?p=d83f7d488f1c4543885926e36b6b173d&pi=2