HPB

LIVER

Since the publication of the ERAS guidelines for liver surgery in 2016, several studies have shown that ERAS in liver surgery improves postoperative complications, diminishes length of stay, and decreases costs (1-5). A total of 23 recommendations, including no prophylactic nasogastric tube use and abdominal drainage, goal-directed fluid therapy, early oral intake, and rapid postoperative mobilization, were recommended in these first guidelines. The updated ERAS guidelines for liver surgery should be published soon in 2022.

Liver References

PANCREAS

The ERAS expert consensus for pancreatoduodenectomy was initially published in 2012, and updated in 2019. These recommendations were based on the best available evidence from more than 300 studies, and processed by the modified Delphi method. For each of the 27 items, a detailed recommendation with a graded level of evidence was provided. Specific items related to pancreatic surgery, such as preoperative biliary drainage, antibioprophylaxis based on bile culture, perianastomotic drainage and perioperative nutrition, are discussed. These recommendations are essential to have a common reference in order to perform additional studies allowing further improvement of perioperative care for pancreatic surgery.