Study population: This is a prospective study that will be conducted on all patients of both sexes and definite age groups attending the National Cancer Institute, Cairo University and candidate for pancreatico-duodenectomy Sampling: all cases fulfilling the inclusion criteria will be included in the study.
Patients will be classified into two groups:
* Group A: Fast track Care pancreatico-duodenectomy.
* Group B: Conventional Care pancreatico-duodenectomy. Baseline demographics, body mass index (BMI), perioperative parameters, postoperative course, postoperative complications and 30-days operative mortality will be analyzed.
Inclusion criteria:
* Age ≤ 75 years
* ASA 1 or 2
* BMI \< 35 The underlying pathology or use of neoadjuvant chemotherapy did not preclude inclusion into the study
Exclusion criteria:
* pancreatico-duodenectomy with vascular reconstruction.
* Unenthusiastic patients.
Type of study: randomized controlled trial The assignment of patients to either group will be done by a random computer-assissted allocation. The allocation will be done by the use of opaque envelopes with assignments.
It's an open-labeled study i.e. patients, investigators (surgeons, researchers) and data collectors will know which procedure will be done to which patients.
Discharge criteria for goup A include; uncomplicated procedure, afebrile patient without tachycardia, tolerance of oral feeding, adequate control of pain with oral analgesia, patient ambulating independently, adequate support at home.
Follow up: will be completed within one month (immediate post-operative outcome).
