Is Current Perioperative Practice in Hepatic Surgery Based on Enhanced Recovery After Surgery (ERAS) Principles?

E. M. Wong-Lun-Hing*, R. M. van Dam, L. A. Heijnen, O. R. C. Busch, T. Terkivatan, R. van Hillegersberg, G. D. Slooter, J. Klaase, J. H. W. de Wilt, K. Bosscha, U. P. Neumann, B. Topal, L. A. Aldrighetti, C. H. C. Dejong

*Corresponding author for this work

Research output: Contribution to journalArticleAcademicpeer-review


-BACKGROUND: The worldwide introduction of multimodal enhanced recovery has also changed perioperative care in patients who undergo liver study was performed to assess current perioperative practice in liver 11 European HPB centers and compare it to enhanced recovery after principles. METHODS: In each unit, 15 consecutive patients (N = 165) who underwent hepatectomy between 2010 and 2012 were retrospectively Compliance was classified as "full," "partial," or "poor" whenever or <50 % of the 22 ERAS protocol core items were met. The primary study was overall compliance with the ERAS core program per unit and per phase. RESULTS: Most patients were operated on for malignancy (91 %) and were minor hepatectomies. The median number of implemented ERAS core (range = 7-12) across all centers. Compliance was partial in the (median 2 of 3 items, range = 1-3) and perioperative phases (median 5 of items, range: 4-7). Median postoperative compliance was poor (median 2 items, range = 0-4). A statistically significant difference was observed median length of stay and median time to recovery (7 vs. 5 days, P < CONCLUSION: Perioperative care among centers that perform liver substantially. In current HPB surgical practice, some elements of the program, e.g., preoperative counselling and minimal fasting, have implemented. Elements in the perioperative phase (avoidance of drains nasogastric tube) and postoperative phase (early resumption of oral mobilization, and use of recovery criteria) should be further optimized.
Original languageEnglish
Pages (from-to)1127-1140
JournalWorld Journal of Surgery
Issue number5
Publication statusPublished - May 2014


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