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Original Article
 
Fast track surgery for biliodigestive derivation: Initial experience
Daniel Rios-Cruz1, Joaquin Valerio-Ureña1, Julio Abraham Hernández-Ascencio1, Patricia Galindo-López2, Veronica Torres-Medina3
1Department of Surgery, High Speciality Hospital of Veracruz. Avenida 20 de noviembre S/N Centro. CP. 91900 Veracruz, Veracruz, México.
2School of Medicine University of Veracruz, México.
3Department of Anesthesiology, High Speciality Hospital of Veracruz. Avenida 20 de noviembre S/N Centro. CP. 91900 Veracruz, Veracruz, México.

Article ID: 100028IJHPDDC2015
doi:10.5348/ijhpd-2015-28-OA-3

Address correspondence to:
Dr. Daniel Rios Cruz
JF Oca # 43 interior 4 entre Amado Nervo y Hernández y Hernández, Colonia Flores Magón
Veracruz, Veracruz,México, C.P. 91900
Phone: (52) 22 97 80 66 11
Fax: (52) 22 97 80 66 11

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How to cite this article
Rios-Cruz D, Valerio-Ureña J, Hernández-Ascencio JA, Galindo-López P, Torres-Medina V. Fast track surgery for biliodigestive derivation: Initial experience. Int J Hepatobiliary Pancreat Dis 2015;5:9–16.


Abstract
Aims: Talk about Fast Track Surgery is referring to a series of measures implemented to accelerate postoperative recovery of the patient. This has been well demonstrated for colorectal surgery with good results. There is very little experience on its application to biliary surgery. The aim of this study is to describe the initial experience of the application of Fast Track Surgery protocol to biliodigestive surgery at high speciality hospital of Veracruz.
Methods: Descriptive, transversal, prospective study. Patients undergoing some kind of biliodigestive derivation, from January 2012 to December 2013 in our hospital under the protocol of Fast Track Surgery, were included.
Results: 12 patients were treated. Nine underwent Hepp-Couinaud type derivation; three, common bile duct-duodedum anastomosis was performed. No patient remained with probes or drains after surgery. The time to start orally was 7.27 ± 2.68 hours; time to start mobilization out of bed was 5.39 ± 2.50 hours. Patients were discharged at 73.68 ± 43.81 hours post-surgical event. Two patients had surgical site infection. No re-admissions were presented.
Conclusion: Application of Fast Track Surgery protocol appears to be safe and feasible. However, it is necessary to expand the sample of patients.

Keywords: Biliary tract, Biliodigestive derivation, Enhanced recovery after surgery, Fast track surgery

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Author Contributions:
Daniel Rios-Cruz – Conception and design, Acquisition of data, Analysis and interpretation of data, Drafting the article, Critical revision of the article, Final approval of the version to be published
Joaquin Valerio-Ureña – Conception and design, Acquisition of data, Analysis and interpretation of data, Drafting the article, Critical revision of the article, Final approval of the version to be published
Julio Abraham Hernández-Ascencio – Conception and design, Acquisition of data, Drafting the article, Critical revision of the article, Final approval of the version to be published
Patricia Galindo-López – Conception and design, Acquisition of data, Drafting the article, Critical revision of the article, Final approval of the version to be published.
Veronica Torres-Medina – Conception and design, Acquisition of data, Drafting the article, Critical revision of the article, Final approval of the version to be published.
Guarantor of submission
The corresponding author is the guarantor of submission.
Source of support
None
Conflict of interest
Authors declare no conflict of interest.
Copyright
© 2015 Daniel Rios-Cruz et al. This article is distributed under the terms of Creative Commons Attribution License which permits unrestricted use, distribution and reproduction in any medium provided the original author(s) and original publisher are properly credited. Please see the copyright policy on the journal website for more information.



About The Authors

Daniel Rios Cruz is Surgeon at Hospital de Alta Especialidad de Veracruz. He earned undergraduate degree of General Medicine from Facultad de Medicina de la Universidad Autonoma de Yucatán, México and postgraduate degree as General Surgeon from Universidad Veracruzana in Veracruz, Veracruz, Mexico. He has a high speciality course in bariatric surgery and laparoscopic gastrointestinal advanced surgery. He has published many research papers in national and international academic journals and authored an electronic book "Topicos selectos de gastroenterologia" wich will be available very soon. His research interests include obesity surgery, hepatopancreatobiliary surgery and fast track surgery.



Joaquin Valerio Ureña is Chief of the division of surgery at Hospital de Alta Especialidad de Veracruz in Mexico. He earned undergraduate degree General Medicine from Universidad Veracruzana and postgraduate degree from General Surgeon from Centro Medico Nacional Siglo XXI del IMSS. He has a highly specialized course in gastrointestinal endoscopy and digestive physiology and motility at Instituto Nacional de Nutricion y Ciencias Médicas Salvador Zubiran in Mexico. He has published many research papers in national and international academic journals and authored chapters in books. His search interests include fast track sugery, gastrointestinal physiology and hepatopancreatobiliary surgery.



Julio Abraham Hernández Ascencio is General Surgeon at Hospital General de Boca del Rio Veracruz, México. He earned undergraduate degree Medico General from Facultad de Medicina de la Universidad Autónoma de Yucatán en Mérida, Yucatán, México and postgraduate degree form Cirujano General from Hospital de Alta Especialidad de Veracruz; Universidad Veracruzana. Veracruz, Veracruz, México. His research interests include gastrointestinal surgery.



Dra. Patricia Galindo López is a medicine student at Facultad de Medicina, Universidad Veracruzana. Her research interest includes gastrointestinal physiology.



Dra Veronica Torres Medina is Anesthesiologist at highly specialized hospital of Veracruz. She studied General Medicine at Universidad Michoacana de San Nicolas de Hidalgo. Morelia, Michoacan, México and Specialty in Anesthesiology in Hospital de Especialidades del Centro Médico Nacional SIGLO XXI, IMSS, México.