After the end of the flowers: the bottleneck and prospect of application of the concept of enhanced recovery after surgery in pancreatic surgery

Patients with pancreatic surgery have a high incidence of preoperative malnutri-tion, large surgical trauma, and many postoperative complications. The practice of enhanced recovery after surgery is difficult. After nearly 20 years of development, the concept of enhanced recovery after surgery (ERAS) has formed mature guidelines and consensus in pancreatic surgery. However, its application is faced with problems such as large central differences, low level of evidence‑based, and insufficient completion of rehabilitation processes. The growth of publications in journals on related topics has stagnated, and the research heat has a trend of ebbing. Based on the literature at home and abroad, the authors analyze the bottleneck of application of enhanced recovery after surgery in pancreatic cancer from the aspects of process management, pre‑rehabilitation and nutrition management, and look forward to the future research direction.