Preliminary results of the implementation of Enhanced Recovery After Surgery (ERAS) program for liver resection in a tertiary center

P. Allemann, E. Uldry, C. Blanc, M. Hübner, N. Demartines

Objective

Enhanced recovery programs (ERAS) have proven to reduce significantly complications, length of stay and cost in colorectal surgery. ERAS pathways were recently extended to other major interventions, such as pancreatic and liver resection. However, the reported experience is still modest and the real clinical benefit should be assessed. The aim of this study was to evaluate short term clinical outcomes of ERAS program in liver resection, and to compare it with standard perioperative care.

Methods

Since July 2013, all patients operated for liver resection in our tertiary center were systematically included in an ERAS program, irrespective of the extend of the resection or the pathology. Items included in our program were critically selected from colorectal and pancreas guidelines published by the ERAS society and were discussed in a multidisciplinary board, including surgeons, anesthesiologists and specialized nurses. Perioperative data were registered in a prospective database. The primary outcome was the 30-day complication rate and the secondary outcome was the length of hospital stay.

Conclusion

ERAS program implementation for liver resection is feasible and safe, even in non-selected patients. These preliminary results show that such clinical pathways may reduce both immediate complication rate and length of hospital stay but need to be confirmed on larger series.