Enhanced Recovery After Surgery® in Octogenarians Undergoing Hepatopancreatobiliary Surgery

Advances in perioperative care have increased the frequency of surgical intervention performed on the very elderly (>= 80 years). This study aims to investigate the impact of Enhanced Recovery After Surgery (ERAS) on outcomes for octogenarians after major hepatopancreatobiliary (HPB) surgery. Patients AO years old in a single HPB ERAS program (September 2015-July 2018) were prospectively tracked in the ERAS Interactive Audit System (EIAS). Postoperative length of stay (LOS) as well as 30-day major complications, readmissions, and mortality were compared to a pre-ERAS octogenarian control. Since ERAS implementation, octogenarians comprised 7.3% (27 of 370) of patients who underwent pancreaticoduodenectomy (n=17), distal pancreatectomy (n=7), or hepatectomy (n=3). Thirty-day readmissions decreased after ERAS implementation (50% to 15%, P=.037). Thirty-day major complications, mortality, and LOS were similar with 64% median protocol compliance. ERAS for octogenarians in HPB surgery is safe and may contribute to more sustainable recovery resulting in reduced readmissions.

Automated summary

Advances in perioperative care have increased the frequency of surgical intervention in patients aged 80 and above. This study investigates the impact of Enhanced Recovery After Surgery (ERAS) on octogenarians undergoing major hepatopancreatobiliary (HPB) surgery. The findings suggest that ERAS implementation in HPB surgery for patients aged 80 and above is safe and may lead to reduced readmissions, with no significant difference in postoperative complications, mortality, and length of stay compared to pre-ERAS cases.