Back to 2025 Abstracts
PREHABILITATION FOR PANCREATECTOMY: ASSESSING FEASIBILITY AND IMPACT ON RECOVERY
Evelyn Alexander
*, Nicholas Galouzis, Maria K. Fotinos, Hunter Alexander, Lusine Mesropyan, Mohammad Khreiss, Taylor S. Riall, Carrie Luu
Banner - University Medical Center Tucson, Tucson, AZ
Introduction
Prehabilitation programs offer targeted preoperative interventions to optimize postoperative outcomes, particularly for complex surgeries like pancreatectomy. This study aimed to evaluate the feasibility of implementing a structured prehabilitation program, the Surgical Oncology and Hepatobiliary Optimization Program (SHOP), and to assess its impact on clinical outcomes for patients undergoing pancreatectomy.
Methods
This single-institution, retrospective study included patients who underwent pancreatic resection from 2020 to 2024. Patients were divided into two groups: the "No SHOP" group (patients treated before SHOP was implemented, from January 2020 to December 2021) and the "SHOP" group (patients treated after SHOP implementation, from January 2023 to June 2024). Variables analyzed included compliance with program components (referrals and scheduling for physical therapy (PT) and nutrition), G8 Frailty scores, time from SHOP referral to surgery, and postoperative outcomes such as length of stay (LOS), complications and time to adjuvant therapy.
Results
The study included 268 patients, with 136 (50.7%) in the No SHOP group and 132 (49.3%) in the SHOP group. The mean age for the total cohort was 64.9 ± 14.7 with 59.7% of patients undergoing pancreaticoduodenectomy. Patients in the SHOP group were more likely to be married (65.2% vs 51.5%, p=0.03), less likely to be a smoker (8.3% vs 16.2, p=0.05), more likely classified as ASA class III (85.6% vs 70.6%, p=0.03), and more likely to undergo surgery for a benign neoplastic (23.5% vs 14.7%) and non-neoplastic indication (11.4% vs 9.5%) (p=0.05). Patients in the SHOP group began adjuvant therapy approximately three weeks earlier than no SHOP patients (55.6 ± 20.3 vs. 79.7 ± 59.3 days, p=0.05), though completion rates were similar between groups (15.9% vs. 24.3%, p=0.09).
G8 frailty assessments were performed after SHOP was implemented and identified a notable portion of frail patients, with 57 (43.2%) classified as frail and 65(49.2%) as not frail in the SHOP group. Mean frailty score was 13.8 ± 2.3. SHOP participants had high compliance with prehabilitation components, including scheduling PT (91.7%) and nutrition (99.2%). Median time from SHOP referral to surgery was 19 days (range: 2–122). There were no differences in complication or readmission rates. However, SHOP participants demonstrated a shorter LOS (6.6 ± 4.2 vs. 9.2 ± 5.9 days, p<0.01).
Conclusion
The SHOP prehabilitation program reduced hospital stays enabling earlier initiation of adjuvant therapy without increasing complications. High compliance rates demonstrate the feasibility and ease of integrating prehabilitation programs into care for pancreatectomy patients. However, the wide variability in time from referral to surgery highlights the value of standardizing referral processes to optimize prehabilitation opportunities.
Back to 2025 Abstracts
