A Cohort Study of an Enhanced Recovery Pathway for Pancreatic Surgery at a Community Hospital

Background: Enhanced recovery after surgery (ERAS) pathways have been shown to improve pancreatic surgery outcomes, though feasibility in a community hospital remain unclear. We hypothesized that an ERAS protocol would reduce hospital length of stay (LOS) without increased morbidity. Methods: An ERAS pathway was initiated for patients undergoing pancreatic surgery at a community cancer center and compared to a historical cohort. The primary outcome was hospital LOS. Secondary outcomes included 30-day readmission rates, comprehensive complication index (CCI (R)), textbook outcomes (TO), and mortality. Results: A total of 144 patients were included, with 63 patients in the ERAS group and 81 in the control group. The mean LOS decreased significantly in the ERAS group (6.85 [+/- 4.8]) vs 9.96 [+/- 6.8] days, P = .001), without an increase in 30-day admission rates or CCI. Conclusions: Implementation of an ERAS protocol in a community setting reduced LOS without a corresponding increase in readmission rates or morbidity.