Is enhancing recovery after pancreatic cancer surgery even possible?—a narrative review

Monish Karunakaran, Savio Barreto

Research output: Contribution to journalReview articlepeer-review

5 Citations (Scopus)
81 Downloads (Pure)


Objective: This narrative review traces the evolutionary journey of ERAS® with emphasis on challenges specific to pancreatic cancer. This article will also attempt to explore the barriers to routine ERAS® implementation and offers possible solutions to increasing its uptake and compliance rates.

Background: Enhanced Recovery After Surgery (ERAS®) represents a paradigm shift in the perioperative management of surgical patients using a multi-modality approach each of which is based on best available evidence. ERAS® has come a long way since its inception and can now be regarded as one of the promising ways forward in the perioperative management of patients undergoing pancreatic surgery.

Methods: We identified 37 studies on the impact of ERAS® in pancreatic surgery, published over the last 2 decades. Implementation of ERAS® helped in shortening the length of stay without an increase in hospital re-admissions, morbidity, or mortality. Compliance to ERAS® is relatively low following pancreatic surgery, with a reported median compliance of 52 %. Elderly patients or those with higher BMI, higher ASA scores, hypoalbuminemia, cardiac comorbidities or longer operative duration are more prone for deviations.

Conclusions: ERAS pathways have been successful in achieving their intended outcomes, despite low compliance. Complementing existing ERAS® pathways with prehabilitation measures, risk-stratified clinical pathways and the accessibility to step-down care facilities following discharge may facilitate its wider utilisation.
Original languageEnglish
Article number49
Number of pages14
JournalChinese Clinical Oncology
Issue number5
Early online date2021
Publication statusPublished - Oct 2021


  • Outcomes
  • Enhanced recovery
  • Pancreatic surgery
  • Quality
  • Compliance


Dive into the research topics of 'Is enhancing recovery after pancreatic cancer surgery even possible?—a narrative review'. Together they form a unique fingerprint.

Cite this