Effect of enhanced recovery after surgery on the rehabilitation of patients undergoing laparoscopic pancreaticoduodenectomy: A meta-analysis.

OBJECTIVE

to thoroughly assess how well patients having laparoscopic pancreaticoduodenectomy (LPD) respond to Enhanced Recovery After Surgery (ERAS) procedures.

METHODS

Up until March 2026, Chinese and English databases (China National Knowledge Infrastructure, Wanfang, VIP, PubMed, Embase, Cochrane, etc.) were searched for randomized controlled trials and cohort studies on the use of ERAS in LPD. Following screening, studies were subjected to data extraction and quality evaluation. RevMan 5.4 was used to conduct the meta-analysis. PROSPERO has this study registered (CRD No.: CRD420251115058).

RESULTS

A total of 18 studies involving 1,672 patients were included. Results showed that implementing ERAS management during the perioperative period for LPD significantly shortened the time to early ambulation (MD = -0.88, 95% CI: -1.36 to -0.40), time to first flatus (MD = -0.97, 95% CI: -1.30 to -0.64), Time to drainage tube removal (MD = -2.25, 95% CI: -2.61 to -1.89), and postoperative hospital stay (MD = -3.67, 95% CI: -4.92 to -2.43). It also effectively reduced the overall complication rate (OR = 0.42, 95% CI: 0.32-0.55), and reduce the incidence of delayed gastric emptying (OR = 0.37, 95% CI: 0.21-0.66) and biliary fistula (OR = 0.30, 95% CI: 0.13-0.69). All differences were statistically significant (P < 0.05).

CONCLUSION

ERAS use in LPD patients is safe and efficient throughout the perioperative phase, greatly accelerating recovery after surgery, lowering the risk of complications, and minimizing hospital stays.