Pain management, fluid therapy and thromboprophylaxis after pancreatoduodenectomy: a worldwide survey among surgeons.

Journal Article (Journal Article)

BACKGROUND: The aim of this survey was to assess practices regarding pain management, fluid therapy and thromboprophylaxis in patients undergoing pancreatoduodenectomy on a global basis. METHODS: This survey study among surgeons from eight (inter)national scientific societies was performed according to the CHERRIES guideline. RESULTS: Overall, 236 surgeons completed the survey. ERAS protocols are used by 61% of surgeons and respectively 82%, 93%, 57% believed there is a relationship between pain management, fluid therapy, and thromboprophylaxis and clinical outcomes. Epidural analgesia (50%) was most popular followed by intravenous morphine (24%). A restrictive fluid therapy was used by 58% of surgeons. Chemical thromboprophylaxis was used by 88% of surgeons. Variations were observed between continents, most interesting being the choice for analgesic technique (transversus abdominis plane block was popular in North America), restrictive fluid therapy (little use in Asia and Oceania) and duration of chemical thromboprophylaxis (large variation). CONCLUSION: The results of this international survey showed that only 61% of surgeons practice ERAS protocols. Although the majority of surgeons presume a relationship between pain management, fluid therapy and thromboprophylaxis and clinical outcomes, variations in practices were observed. Additional studies are needed to further optimize, standardize and implement ERAS protocols after pancreatic surgery.

Full Text

Duke Authors

Cited Authors

  • Groen, JV; Henrar, RB; Hanna Sawires, RG; AlEassa, E; Martini, CH; Bonsing, BA; Vahrmeijer, AL; Besselink, MG; Pecorelli, N; Hackert, T; Ishizawa, T; Miller, T; Mungroop, TH; Samra, J; Sauvanet, A; Adham, M; Demartines, N; Christophi, C; Morris-Stiff, G; Mieog, JSD

Published Date

  • April 2022

Published In

Volume / Issue

  • 24 / 4

Start / End Page

  • 558 - 567

PubMed ID

  • 34629261

Electronic International Standard Serial Number (EISSN)

  • 1477-2574

Digital Object Identifier (DOI)

  • 10.1016/j.hpb.2021.09.006


  • eng

Conference Location

  • England