加速康复外科在胰腺外科中的应用

Application of enhanced recovery after surgery in pancreatic surgery

加速康复外科（ERAS）包括术前对患者进行宣传教育，术中有效的麻醉、镇痛及精确的外科技术以及术后早期康复治疗。由于胰腺解剖位置的特殊和胰腺手术本身技术难度高，学习曲线长，患者术后并发症发生率高，加速康复的实践在胰腺外科的应用始终不广泛。但ERAS能减少手术应激，降低术后并发症发生率，加速患者术后康复，缩短术后住院时间，降低住院费用的优势已被许多临床研究证实，也是胰腺外科发展的方向。如何在追求最佳预后与加速康复上找到最佳平衡点是胰腺外科医师应该重视和思考的问题。

Enhanced recovery after surgery （ERAS） includes preoperative education, intraoperative effective anaes- thetization, analgesia, precision surgical techniques and post- operative early rehabilitation. Because of special location of the pancreas, difficulty of surgical techniques, longtime of learning and high incidence of postoperative complications, the applica- tion of ERAS in pancreatic surgery is restricted. While ERAS could reduce the stress after surgery and the incidence of compli- cations, promote the recovery of patients, shorten the duration of hospital stay and reduce the expenses, which are confirmed by clinical practice. ERAS is the trend of the development of pan- creatic surgery. How to balance the optimal prognosis and speed recovery is need to be resolved by pancreatic surgeons.