Copyright ©The Author(s) 2018.
World J Gastroenterol. Apr 21, 2018; 24(15): 1666-1678
Published online Apr 21, 2018. doi: 10.3748/wjg.v24.i15.1666
Table 1 The search strategy for the PubMed database1
Search numberDescriptionNumber of publications
1Enhanced recovery after surgery [Title/Abstract] OR ERAS [Title/Abstract] OR fast track surgery [Title/Abstract]3333
2Clinical pathways [MeSH Terms]5848
31 OR 29130
4Pancreatectomy [MeSH Terms] OR Pancreatectomy* [Title/Abstract] OR Pancreatoduodenectomy [MeSH Terms] OR Pancreatoduodenectom* [Title/Abstract] OR duodenopancreatectomy [MeSH Terms] OR duodenopancreatectom* [Title/Abstract]21497
53 AND 4 NOT (animals[mh] NOT humans[mh])69
65 limited to English68
Table 2 Study Characteristics and Quality Assessment.
StudyYearCountryStudy designSample size
ERAS programs1MINORS Score
ERAS groupControl group
Kennedy et al[14]2007United StatesCase-control9144e, f, g, h16/24
Vanounou et al[15]2007United StatesCase-control14564c, d, g, h15/24
Balzano et al[16]2008ItalyCase-control252252d, e, f, g, h13/24
Kennedy et al[17]2009United StatesCase-control7140d, e, f, g, h11/24
Abu Hilal et al[18]2013BritainCase-control2024b, e, f, g, h15/24
Braga et al[19]2014ItalyCase-control115115a, b, c, d, e, f, g, h17/24
Pillai et al[20]2014IndiaCase-control2020c, d, e, f, g, h17/24
Coolsen et al[21]2014HollandCase-control8697b, c, d, e, f, g, h12/24
Nussbaum et al[22]2014United StatesCase-control100142c, e, f, g, h11/24
Yui et al[23]2014JapanCase-control5752e, g, h13/24
Nussbaum et al[24]2014United StatesCase-control50100c, e, f, g, h16/24
Kobayashi et al[25]2014JapanCase-control10090a, e, g, h13/24
Shao et al[26]2015ChinaCase-control325310d, e, f, g, h15/24
Joliat et al[27]2015SwitzerlandCase-control7487a, b, c, d, e, f, g, h15/24
Partelli et al[28]2015ItalyCase-control2266a, c, d, e, f, g, h13/24
Williamsson et al[29]2015SwedenCase-control5050c, d, e, f, g, h17/24
Morales Soriano et al[30]2015SpainCase-control4144a, b, c, d, e, f, g, h17/24
Bai et al[31]2016ChinaCase-control12463a, d, e, f, g, h15/24
Zouros et al[32]2016GreeceCase-control7550a, b, c, d, e, f, g, h16/24
Dai et al[33]2017ChinaCase-control6898a, b, c, e, f, g, h15/24
Table 3 Results of Subgroup Analysis
Outcomes of interestStudiesPatientsOR/WMD95%CIP-valueHeterogeneity P-valueI2, %
Studies with cases ≥ 100
DGE1431170.580.47-0.71< 0.000010.0739
Overall complications1430450.570.45-0.72< 0.000010.00655
Mild complications914700.740.59-0.930.0090.0646
Abdominal infection1020870.670.51-0.870.0030.0742
PLOS102394-4.64-6.37 to -2.91< 0.000010.00965
Unintended reoperation919550.850.60-1.210.380.960
MINORS score > 12
DGE1629490.520.42-0.64< 0.000010.1231
Overall complications1630080.560.44-0.71< 0.000010.0151
Mild complications1115040.670.54-0.830.00030.2421
Abdominal infection1017910.630.46-0.850.0020.0546
PLOS112272-4.35-5.97 to -2.72< 0.000010.00366
Unintended reoperation1117870.960.65-1.410.830.940
Table 4 Results of sensitivity analysis by omitting one study in each turn
Omitting Vanounou et al[15]0.560.44-0.72< 0.00001
Omitting Kennedy et al[14]0.560.44-0.71< 0.00001
Omitting Balzano et al[16]0.560.43-0.73< 0.0001
Omitting Kennedy et al[17]0.580.46-0.74< 0.00001
Omitting Abu Hilal et al[18]0.580.45-0.73< 0.00001
Omitting Yui et al[23]0.560.44-0.72< 0.00001
Omitting Kobayashi et al[25]0.580.45-0.74< 0.00001
Omitting Coolsen et al[21]0.540.43-0.69< 0.00001
Omitting Braga et al[19]0.550.43-0.71< 0.00001
Omitting Pillai et al[20]0.570.45-0.73< 0.00001
Omitting Joliat et al[27]0.570.45-0.73< 0.0001
Omitting Partelli et al[28]0.550.44-0.68< 0.00001
Omitting Williamsson et al[29]0.560.44-0.71< 0.00001
Omitting Morales Soriano et al[30]0.580.46-0.74< 0.00001
Omitting Shao et al[26]0.570.44-0.74< 0.0001
Omitting Zouros et al[32]0.570.44-0.73< 0.00001
Omitting Bai et al[31]0.560.44-0.71< 0.00001
Omitting Dai et al[33]0.620.52-0.71< 0.00001
Overall effect0.570.45-0.72< 0.00001