ERAS: Improving outcome in the cachectic HPB patient

David P J van Dijk; Victor van Woerden; Hamit Cakir; Marcel den Dulk; Steven W M Olde Damink; Cornelis H C Dejong

doi:10.1002/jso.24767

ERAS: Improving outcome in the cachectic HPB patient

J Surg Oncol. 2017 Oct;116(5):617-622. doi: 10.1002/jso.24767. Epub 2017 Aug 2.

Authors

David P J van Dijk^{1

2}, Victor van Woerden^{1

2}, Hamit Cakir¹, Marcel den Dulk^{1

3}, Steven W M Olde Damink^{1

2

3}, Cornelis H C Dejong^{1

2

3

4}

Affiliations

¹ Department of Surgery, Maastricht University Medical Centre, Maastricht, The Netherlands.
² NUTRIM School of Nutrition and Translational Research in Metabolism, Maastricht University, Maastricht, The Netherlands.
³ Department of General, Visceral and Transplantation Surgery, RWTH University Hospital Aachen, Aachen, Germany.
⁴ GROW School for Oncology and Developmental Biology, Maastricht University, Maastricht, The Netherlands.

Abstract

The enhanced recovery after surgery (ERAS) program has reduced postoperative morbidity and duration of hospital stay but not mortality in patients undergoing hepatopancreatobiliary (HPB) surgery. Many HPB patients suffer from cancer cachexia, a syndrome of severe weight and muscle loss. This may affect outcomes of HPB surgery even within an ERAS program. A tailored ERAS approach may be essential in further improving outcome in this vulnerable patient category.

Keywords: body composition; cancer cachexia; enhanced recovery after surgery; hepatopancreatobiliary surgery; outcome.

Publication types

Review

MeSH terms

Biliary Tract Surgical Procedures / methods
Cachexia / physiopathology*
Digestive System Surgical Procedures / methods*
Humans
Intraoperative Care / methods*
Liver / surgery
Neoplasms / metabolism
Pancreas / surgery
Treatment Outcome