Fas-Track-Chirurgie beim Pankreaskarzinom

The beneficial clinical effects of fast track surgery reported here in a prospective clinical feasibility study compared with age-, sex-, and disease-matched historical control patients clearly indicate that the modified concept of multimodal rehabilitation can safely be applied in pancreatic cancer patients, in particular in patients who undergo partial pancreatoduodenectomy (traditional KAUSCH-WHIPPLE procedure) or pylorus preserving partial pancreatoduodenectomy. Thus, our results further support previous findings that the multimodal approach to perioperative patient care with revision of surgical traditions (pre- and postoperative starvation, immobilisation, abdominal drains) and optimised pain treatment using epidural analgesia has the potential to improve postoperative recovery even in high risk patients. While routine laboratory parameters show similar changes during the postoperative course after pancreatic cancer surgery in both groups, the clinical outcome parameters clearly indicate that the concept of fast track rehabilitation can be successfully transferred to pancreatic surgery and may be even beneficially applied to these high-risk patients. Further randomized clinical trials are necessary to prove the concept of multimodal rehabilitation in pancreatic cancer surgery.