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Resumen Introduccion La Fast-track surgery se ha planteado recientemente como un programa eficaz en la cirugia pancreatica. Aunque la morbimortalidad tras la duodenopancreatectomia cefalica ha mejorado en la ultima decada, la prevalencia de complicaciones postoperatorias continua siendo elevada. El objetivo de este trabajo es examinar los resultados de un programa de Fast-track en este tipo de intervenciones. Resultados Ochenta y dos pacientes fueron intervenidos de duodenopancreatectomia cefalica dentro de un protocolo de recuperacion precoz. La mediana de edad fue 63 anos. El 65% fueron varones. La mediana de estancia hospitalaria fue de 9 dias, con un 14,6% de reingresos. Se aplico la clasificacion de Clavien-DeOliveira para evaluar la severidad de las complicaciones. La morbilidad global fue del 47,6%. La complicacion mas frecuente correspondio al grupo que englobaba las generales, seguidas por la infeccion de la herida quirurgica y complicaciones cardiorrespiratorias. Teniendo en cuenta que solo el 32% de los pacientes tuvieron drenaje desde la cirugia, la frecuencia de fistula pancreatica fue del 8,5%, y esta se situaba en los grupos de mayor morbilidad (grados III, IV y V). La mortalidad postoperatoria fue del 4,9%. La cirugia asociada constituyo un factor de riesgo para la mortalidad. Conclusiones La Fast-track surgery en la duodenopacreatectomia cefalica realizada en centros de alto volumen es un programa seguro y eficaz que permite ademas mejorar los resultados de morbimortalidad.

The surgical treatment of benign tumors of the neck of the pancreas usually consists of enucleation or formal pancreatectomy. Central pancreatectomy has been put forward because it has fewer major complications and can preserve endocrine and exocrine function. Between January 1999 and march 2003, three patients with benign tumors of the neck of the pancreas underwent central pancreatectomy. all patients underwent computed tomography scans, intraoperative ultrasound and frozen-section analysis. pathologic examination showed two mucinous cystadenomas and one serous cystadenoma. after a mean follow-up of 34 months, none of the patients has shown major complications or local recurrence, or has developed diabetes. In conclusion, central pancreatectomy is a useful technique for selected benign or low-grade malignant pancreatic tumors of the neck of the pancreas.

Introduction Fast-track surgery has been proposed as a valid method in pancreatic surgery. Although morbidity and mortality has improved in the last decade, the prevalence of postoperative complications is still high. The aim of this study is to analyse the results of a programme of Fast-track surgery in this context. Results A total of 82 patients who underwent a cephalic pancreatoduodenectomy with a programme of early recovery after surgery, were analysed. There were 53 men, with a median age of 63 years old. The median hospital stay was 9 days, with 14.6% of readmissions. The Clavien-DeOliveira Classification was applied to evaluate the severity of postoperative complications. The overall morbidity was 47.6%. The most common complications were general, followed by infection of surgical wound and cardiopulmonary events. Taking into account that a surgical drain was used in 32% of patients, the prevalence of pancreatic fistula was 8.5%, and were classified in the most severity grades (III, IV, and V). The postoperative mortality was 4.9%. The associated surgery was a risk factor of mortality. Conclusions The Fast-track programme after pancreatoduodenectomy in high volume centres is a safe and effective method, that can improve the morbidty and mortality results.

The surgical treatment of benign tumors of the neck of the pancreas usually consists of enucleation or formal pancreatectomy. Central pancreatectomy has been put forward because it has fewer major complications and can preserve endocrine and exocrine function. Between January 1999 and march 2003, three patients with benign tumors of the neck of the pancreas underwent central pancreatectomy. all patients underwent computed tomography scans, intraoperative ultrasound and frozen-section analysis. pathologic examination showed two mucinous cystadenomas and one serous cystadenoma. after a mean follow-up of 34 months, none of the patients has shown major complications or local recurrence, or has developed diabetes. In conclusion, central pancreatectomy is a useful technique for selected benign or low-grade malignant pancreatic tumors of the neck of the pancreas.