Background and Aims: Over the past years, the concept of enhanced recovery after surgery (ERAS) has applied in a variety of surgical fields, and achieved remarkable results. However, the application of ERAS in the perioperative period of pancreaticoduodenectomy (PD) is still limited. Therefore, this study was conducted to explore the application value of ERAS in perioperative management of PD through a prospective clinical analysis. 
Methods: A prospective series of 101 consecutive patients undergoing PD in the Department of Pancreatic Surgery, Xiangya Hospital, Central South University from December 2017 to September 2019 were enrolled. Of these patients, 32 cases adopted ERAS clinical pathway for perioperative management (ERAS group) and 69 cases received conventional protocols for perioperative management (conventional group). The clinical results were compared between the two groups of patients. 
Results: Compared to conventional group, the intraoperative blood loss of patients in ERAS group was significantly reduced (P<0.05). Moreover, the postoperative albumin level in ERAS group was significantly higher than that in conventional group, the time to the first postoperative anal gas passage and ambulation as well as the length of postoperative hospital stay were significantly shorter in ERAS group than those in conventional group, and the hospitalization cost in ERAS group was significantly lower in ERAS group than that in conventional group (all P<0.05). In terms of postoperative complications, the overall incidence of postoperative complication, the incidence rates of postoperative pancreatic fistula and pulmonary complications as well as proportion of cases with severe complications were significantly decreased in ERAS group compared with conventional group (all P<0.05).
Conclusion: The clinical application of ERAS protocols for perioperative management of PD is safe and feasible, which can effectively reduce the incidence of postoperative complications and accelerate the recovery of patients.