{"title":"Comparative study of ambulatory versus inpatient laparoscopic cholecystectomy in Thailand: Assessing effectiveness and safety with a propensity score matched analysis.","authors":"Nattawut Keeratibharat, Sirada Patcharanarumol, Sarinya Puranapanya, Supat Phupaibul, Nattaporn Khomweerawong, Jirapa Chansangrat","doi":"10.14701/ahbps.24-056","DOIUrl":"10.14701/ahbps.24-056","url":null,"abstract":"<p><strong>Backgrounds/aims: </strong>Ambulatory laparoscopic cholecystectomy (LC) is increasingly recognized for its advantages over the inpatient approach, which advantages include cost-effectiveness and faster recovery. However, its acceptance is limited by patient concerns regarding safety, and the potential for postoperative complications. The study aims to compare the operative and postoperative outcomes of ambulatory LC versus inpatient LC, specifically addressing patient hesitations related to early discharge.</p><p><strong>Methods: </strong>In a retrospective analysis, patients who underwent LC were divided into ambulatory or inpatient groups based on American Society of Anesthesiologists (ASA) classification, age, and the availability of postoperative care. Propensity score matching was utilized to ensure comparability between the groups. Data collection focused on demographic information, perioperative data, and postoperative follow-up results to identify the safety of both approaches.</p><p><strong>Results: </strong>The study included a cohort of 220 patients undergoing LC, of which 48 in each group matched post-propensity score matching. The matched analysis indicated that ambulatory LC patients seem to experience shorter operative times and reduced blood loss, but these differences were not statistically significant (35 minutes vs. 46 minutes, <i>p</i>-value = 0.18; and 8.5 mL vs. 23 mL, <i>p</i>-value = 0.14, respectively). There were no significant differences in complication rates or readmission frequencies, compared to the inpatient cohort.</p><p><strong>Conclusions: </strong>Ambulatory LC does not compromise safety or efficacy, compared to traditional inpatient procedures. The findings suggest that ambulatory LC could be more widely adopted, with appropriate patient education and selection criteria, to alleviate concerns and increase patient acceptance.</p>","PeriodicalId":72220,"journal":{"name":"Annals of hepato-biliary-pancreatic surgery","volume":null,"pages":null},"PeriodicalIF":1.1,"publicationDate":"2024-08-31","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11341881/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141066145","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
{"title":"Komi type 2 pancreaticobiliary maljunction: Minimal access surgical treatment (with video).","authors":"Freddy Pereira Graterol, Francisco Salazar Marcano, Yeisson Rivero-Moreno, Yajaira Venales Barrios","doi":"10.14701/ahbps.24-063","DOIUrl":"10.14701/ahbps.24-063","url":null,"abstract":"<p><p>Pancreaticobiliary maljunction (PBM) is associated with the development of neoplasms of bile ducts. Cholecystectomy with diversion of the biliary-pancreatic flow is considered the treatment of choice. To describe the surgical treatment employed for a patient with Komi's type 2 PBM and its long-term results. Laparoscopic common bile duct exploration, intraoperative cholangioscopy, and Roux-en-Y hepatico-jejunostomy were performed. Postoperative evolution was satisfactory. The patient was discharge 72 hours after the surgery. There was no associated morbidity. At 62-month follow-up, clinical examination, laboratory tests, and imaging studies confirmed an adequate patency of bilio-enteric anastomosis. The surgical approach employed was effective and safe, with satisfactory long-term results.</p>","PeriodicalId":72220,"journal":{"name":"Annals of hepato-biliary-pancreatic surgery","volume":null,"pages":null},"PeriodicalIF":1.1,"publicationDate":"2024-08-31","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11341884/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141312376","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
{"title":"Efficacy of the omental roll-up technique in pancreaticojejunostomy to prevent postoperative pancreatic fistula after pancreaticoduodenectomy.","authors":"Sisira Jayaratnam, Cherring Tandup, Yashwant Raj Sakaray, Kailash ChKurdia, Ashish Gupta, Lileswar Kaman","doi":"10.14701/ahbps.24-016","DOIUrl":"10.14701/ahbps.24-016","url":null,"abstract":"<p><strong>Backgrounds/aims: </strong>Pancreaticoduodenectomy (PD) is being performed more frequently. A pancreaticojejunostomy (PJ) leak is the major determinant of patient outcomes. An omental flap around PJ might improve postoperative outcomes.</p><p><strong>Methods: </strong>A prospective randomized controlled trial was planned at PGIMER, Chandigarh. Fifty-eight patients meeting the criteria were included in the study. Group A underwent PD with omental roll-up and group B underwent standard PD.</p><p><strong>Results: </strong>The mean age of patients in group A was 57.1 ± 14.3 years and 51.2 ± 10.7 in group B. Jaundice (<i>p</i> = 0.667), abdominal pain (<i>p</i> = 0.69), and co-morbidities were equal among the groups. The body mass index of patients in group B was higher at 24.3 ± 5.4 kg/m<sup>2</sup> (<i>p</i> = 0.03). The common bile duct diameter (12.6 ± 5.3 mm vs. 17.2 ± 10.3 mm, <i>p</i> = 0.13) and the pancreatic duct diameter (4.06 ± 2.01 mm vs. 4.60 ± 2.43 mm, <i>p</i> = 0.91) were comparable. The intraoperative blood loss (mL) was significantly higher in group B (233.33 ± 9.57 vs. 343.33 ± 177.14, <i>p</i> = 0.04). Drain fluid amylase levels on postoperative day (POD) 1 (<i>p</i> = 0.97) and POD3 (<i>p</i> = 0.92) were comparable. The rate of postoperative pancreatic fistula (POPF) grade A (<i>p</i> ≥ 0.99) and grade B (<i>p</i> = 0.54) were comparable. The mean postoperative length of stay among was similar (<i>p</i> = 0.89).</p><p><strong>Conclusions: </strong>An omental wrap can be performed without increase in complexity of the procedure. However, its utility in preventing POPFs and morbidity remains unclear.</p>","PeriodicalId":72220,"journal":{"name":"Annals of hepato-biliary-pancreatic surgery","volume":null,"pages":null},"PeriodicalIF":1.1,"publicationDate":"2024-08-31","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11341888/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141248711","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Alexandra Nassar, Théo Braquet, Béatrice Aussilhou, Maxime Ronot, Emmanuel Weiss, Federica Dondéro, Mickael Lesurtel, Safi Dokmak
{"title":"Hepatic compartment syndrome, a rare complication after any liver insult or liver transplantation: Three case reports and literature review.","authors":"Alexandra Nassar, Théo Braquet, Béatrice Aussilhou, Maxime Ronot, Emmanuel Weiss, Federica Dondéro, Mickael Lesurtel, Safi Dokmak","doi":"10.14701/ahbps.24-040","DOIUrl":"10.14701/ahbps.24-040","url":null,"abstract":"<p><p>Hepatic compartment syndrome (HCS) is a rare but life-threatening entity that consists of a decreased portal flow due to intraparenchymal hypertension secondary to subcapsular liver hematoma. Lethal liver failure can be observed. We report three cases, and review the literature. A 54-year-old male was admitted for extensive hepatic subcapsular hematoma after blunt abdominal trauma. Initially, he underwent embolization of the hepatic artery's right branch, after which he presented clinical deterioration, major cytolysis (310 times the upper limit of normal [ULN]), and liver failure with a prothrombin time (PT) at 31.0%. A 56-year-old male underwent liver transplantation for acute alcoholic hepatitis. On postoperative day 2, he presented a hemorrhagic shock associated with deterioration of liver function (cytolysis 21 ULN, PT 39.0%) due to extensive hepatic subcapsular hematoma. A 59-year-old male presented a hepatic subcapsular hematoma five days after a cholecystectomy, revealed by abdominal pain with liver dysfunction (cytolysis 10 ULN, PT 63.0%). All patients ultimately underwent urgent surgery for liver capsule excision, hematoma evacuation, and liver packing, if needed. The international literature was screened for this entity. These three patients' outcomes were favorable, and all were alive at postoperative day 90. The literature review found 15 reported cases. HCS can occur after any direct or indirect liver trauma. Surgical decompression is the main treatment, and there is probably no place for arterial embolization, which may increase the risk of liver necrosis. A 13.3% mortality rate is reported. HCS is a rare complication of subcapsular liver hematoma that compresses the liver parenchyma, and leads to liver failure. Urgent surgical decompression is needed.</p>","PeriodicalId":72220,"journal":{"name":"Annals of hepato-biliary-pancreatic surgery","volume":null,"pages":null},"PeriodicalIF":1.1,"publicationDate":"2024-08-31","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11341880/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141312375","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Jongman Kim, Jinsoo Rhu, Eunjin Lee, Youngju Ryu, Sunghyo An, Sung Jun Jo, Namkee Oh, Seungwook Han, Sunghae Park, Gyu-Seong Choi
{"title":"Left lobe living donor liver transplantation using the resection and partial liver segment 2-3 transplantation with delayed total hepatectomy (RAPID) procedure in cirrhotic patients: First case report in Korea.","authors":"Jongman Kim, Jinsoo Rhu, Eunjin Lee, Youngju Ryu, Sunghyo An, Sung Jun Jo, Namkee Oh, Seungwook Han, Sunghae Park, Gyu-Seong Choi","doi":"10.14701/ahbps.24-005","DOIUrl":"10.14701/ahbps.24-005","url":null,"abstract":"<p><p>In liver transplantation, the primary concern is to ensure an adequate future liver remnant (FLR) volume for the donor, while selecting a graft of sufficient size for the recipient. The living donor-resection and partial liver segment 2-3 transplantation with delayed total hepatectomy (LD-RAPID) procedure offers a potential solution to expand the donor pool for living donor liver transplantation (LDLT). We report the first case involving a cirrhotic patient with autoimmune hepatitis and hepatocellular carcinoma, who underwent left lobe LDLT using the LD-RAPID procedure. The living liver donor (LLD) underwent a laparoscopic left hepatectomy, including middle hepatic vein. The resection on the recipient side was an extended left hepatectomy, including the middle hepatic vein orifice and caudate lobe. At postoperative day 7, a computed tomography scan showed hypertrophy of the left graft from 320 g to 465 mL (i.e., a 45.3% increase in graft volume body weight ratio from 0.60% to 0.77%). After a 7-day interval, the diseased right lobe was removed in the second stage surgery. The LD-RAPID procedure using left lobe graft allows for the use of a small liver graft or small FLR volume in LLD in LDLT, which expands the donor pool to minimize the risk to LLD by enabling the donation of a smaller liver portion.</p>","PeriodicalId":72220,"journal":{"name":"Annals of hepato-biliary-pancreatic surgery","volume":null,"pages":null},"PeriodicalIF":1.1,"publicationDate":"2024-08-31","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11341882/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"140332362","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Yun Zhao, Ivan En-Howe Tan, Vikneswary D/O A Jahnasegar, Hui Min Chong, Yonghui Chen, Brian Kim Poh Goh, Marianne Kit Har Au, Ye Xin Koh
{"title":"Evaluation of the impact of prospective payment systems on cholecystectomy: A systematic review and meta-analysis.","authors":"Yun Zhao, Ivan En-Howe Tan, Vikneswary D/O A Jahnasegar, Hui Min Chong, Yonghui Chen, Brian Kim Poh Goh, Marianne Kit Har Au, Ye Xin Koh","doi":"10.14701/ahbps.24-038","DOIUrl":"10.14701/ahbps.24-038","url":null,"abstract":"<p><p>This systematic review and meta-analysis aimed to evaluate the impact of prospective payment systems (PPSs) on cholecystectomy. A comprehensive literature review was conducted, examining studies published until December 2023. The review process focused on identifying research across major databases that reported critical outcomes such as length of stay (LOS), mortality, complications, admissions, readmissions, and costs following PPS for cholecystectomy. The studies were specifically selected for their relevance to the impact of PPS or the transition from fee-for-service (FFS) to PPS. The study analyzed six papers, with three eligible for meta-analysis, to assess the impact of the shift from FFS to PPS in laparoscopic and open cholecystectomy procedures. Our findings indicated no significant changes in LOS and mortality rates following the transition from FFS to PPS. Complication rates varied and were influenced by the diagnosis-related group categorization and surgeon cost profiles under episode-based payment. There was a slight increase in admissions and readmissions, and mixed effects on hospital costs and financial margins, suggesting varied responses to PPS for cholecystectomy procedures. The impact of PPS on cholecystectomy is nuanced and varies across different aspects of healthcare delivery. Our findings indicate a need for adaptable, patient-centered PPS models that balance economic efficiency with high-quality patient care. The study emphasizes the importance of considering specific surgical procedures and patient demographics in healthcare payment reforms.</p>","PeriodicalId":72220,"journal":{"name":"Annals of hepato-biliary-pancreatic surgery","volume":null,"pages":null},"PeriodicalIF":1.1,"publicationDate":"2024-08-31","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11341890/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"140867741","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Shahin Hajibandeh, Shahab Hajibandeh, Daisy Evans, Tejinderjit S Athwal
{"title":"Meta-analysis of pancreatic re-resection for locally recurrent pancreatic cancer following index pancreatectomy.","authors":"Shahin Hajibandeh, Shahab Hajibandeh, Daisy Evans, Tejinderjit S Athwal","doi":"10.14701/ahbps.24-041","DOIUrl":"10.14701/ahbps.24-041","url":null,"abstract":"<p><p>The role of surgical resection in patients with recurrent pancreatic cancer is unclear. We aimed to evaluate the survival outcomes of pancreatic re-resection for locally recurrent pancreatic cancer following index pancreatectomy. A literature search was carried out in CENTRAL, EMBASE, MEDLINE, CINAHL, and Web of Science. Proportion meta-analysis model was constructed to quantify 1 to 5-year survival after pancreatic re-resection for locally recurrent pancreatic cancer. Random-effects modelling was applied to calculate pooled outcome data. Fifteen retrospective studies were included, reporting a total of 250 patients who underwent pancreatic re-resection for locally recurrent pancreatic cancer following their index pancreatectomy. Pancreatic re-resection was associated with 1-year survival 70.6% (95% confidence interval [CI], 65.0-76.2), 2-year survival 38.8% (95% CI, 28.6-49.0), 3-year survival 20.2% (95% CI, 13.8-26.7), and 5-year survival 9.2% (95% CI, 5.5-12.8). The between-study heterogeneity was insignificant in all outcome syntheses. Repeat pancreatectomy for local recurrence of pancreatic cancer in the remnant pancreas following the index pancreatectomy is associated with acceptable overall patient survival. We recommend selective re-resection of such recurrences in younger patients with favorable tumor size and location. Our findings may encourage more robust studies to be conducted in this context to provide stronger evidence.</p>","PeriodicalId":72220,"journal":{"name":"Annals of hepato-biliary-pancreatic surgery","volume":null,"pages":null},"PeriodicalIF":1.1,"publicationDate":"2024-08-31","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11341876/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141158972","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
{"title":"Turning points in the practice of liver surgery: A historical review.","authors":"Giovanni Domenico Tebala, Stefano Avenia, Roberto Cirocchi, Antonella Delvecchio, Jacopo Desiderio, Domenico Di Nardo, Francesca Duro, Alessandro Gemini, Felice Giuliante, Riccardo Memeo, Gennaro Nuzzo","doi":"10.14701/ahbps.24-039","DOIUrl":"10.14701/ahbps.24-039","url":null,"abstract":"<p><p>The history of liver surgery is a tale of progressive resolution of issues presenting one after another from ancient times to the present days when dealing with liver ailments. The perfect knowledge of human liver anatomy and physiology and the development of a proper liver resective surgery require time and huge efforts and, mostly, the study and research of giants of their own times, whose names are forever associated with anatomical landmarks, thorough descriptions, and surgical approaches. The control of parenchymal bleeding after trauma and during resection is the second issue that surgeons have to resolve. A good knowledge of intra and extrahepatic vascular anatomy is a necessary condition to develop techniques of vascular control, paving the way to liver transplantation. Last but not least, the issue of residual liver function after resection requires advanced techniques of volume redistribution through redirection of blood inflow. These are the same problems any young surgeon would face when approaching liver surgery for the first time. Therefore, obtaining a wide picture of historical evolution of liver surgery could be a great starting point to serve as an example and a guide.</p>","PeriodicalId":72220,"journal":{"name":"Annals of hepato-biliary-pancreatic surgery","volume":null,"pages":null},"PeriodicalIF":1.1,"publicationDate":"2024-08-31","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11341877/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"140945781","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
{"title":"Does perioperative hydrocortisone or indomethacin improve pancreatoduodenectomy outcomes? A triple arm, randomized placebo-controlled trial.","authors":"Kislay Kant, Zeeshan Ahmed, Rohit Dama, Monish Karunakaran, Prateek Arora, Pradeep Rebala, Guduru Venkat Rao","doi":"10.14701/ahbps.24-021","DOIUrl":"10.14701/ahbps.24-021","url":null,"abstract":"<p><strong>Backgrounds/aims: </strong>This trial evaluated whether anti-inflammatory agents hydrocortisone (H) and indomethacin (I) could reduce major complications after pancreatoduodenectomy (PD).</p><p><strong>Methods: </strong>Between June 2018 and June 2020, 105 patients undergoing PD with > 40% of acini on the intraoperative frozen section were randomized into three groups (35 patients per group): 1) intravenous H 100 mg 8 hourly, 2) rectal I suppository 100 mg 12 hourly, and 3) placebo (P) from postoperative day (POD) 0-2. Participants, investigators, and outcome assessors were blinded. The primary outcome was major complications (Clavien-Dindo grades 3-5). Secondary outcomes were overall complications (Clavien-Dindo grades 1-5), Clinically relevant postoperative pancreatic fistula (CR-POPF), delayed gastric emptying (DGE), postpancreatectomy hemorrhage (PPH), surgical site infections (SSI), length of stay, POD-3 serum amylase, readmission rate, and mortality.</p><p><strong>Results: </strong>Major complications were comparable (8.6%, 5.7%, and 8.6% in groups H, I, and P, respectively). However, overall complications were significantly lower in group H than in group P (45.7% vs. 80.0%, <i>p</i> = 0.006). CR-POPF (14.3% vs. 25.7%, <i>p</i> = 0.371), PPH (8.6% vs. 14.3%, <i>p</i> = 0.710), DGE (8.6% vs. 22.9%, <i>p</i> = 0.188), and SSI (14.3% vs. 25.7%, <i>p</i> = 0.371) were comparable between groups H and P. Major complications and overall complications in group I were 5.7% and 60.0%, respectively, which were comparable to those in groups P and H. CR-POPF rates in groups H, I, and P were 14.3%, 17.1%, and 25.7%, respectively, which was comparable.</p><p><strong>Conclusions: </strong>H and I did not decrease major complications in PD.</p>","PeriodicalId":72220,"journal":{"name":"Annals of hepato-biliary-pancreatic surgery","volume":null,"pages":null},"PeriodicalIF":1.1,"publicationDate":"2024-08-31","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11341883/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"140854496","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Mohamad Younis Bhat, Sadaf Ali, Sonam Gupta, Younis Ahmad, Mohd Riyaz Lattoo, Mohammad Juned Ansari, Ajay Patel, Mohd Fazl Ul Haq, Shaheena Parveen
{"title":"Feasibility, safety and effectiveness of the enhanced recovery after surgery protocol in patients undergoing liver resection.","authors":"Mohamad Younis Bhat, Sadaf Ali, Sonam Gupta, Younis Ahmad, Mohd Riyaz Lattoo, Mohammad Juned Ansari, Ajay Patel, Mohd Fazl Ul Haq, Shaheena Parveen","doi":"10.14701/ahbps.24-034","DOIUrl":"10.14701/ahbps.24-034","url":null,"abstract":"<p><strong>Backgrounds/aims: </strong>The implementation of enhanced recovery after surgery (ERAS) protocols has demonstrated significant advantages for patients by mitigating surgical stress and expediting recovery across a spectrum of surgical procedures worldwide. This investigation seeks to assess the effectiveness of the ERAS protocol specifically in the context of major liver resections within our geographical region.</p><p><strong>Methods: </strong>Our department conducted retrospective analysis of prospectively collected data, gathered from consenting individuals who underwent liver resections from January 2018 to December 2023. The assessment encompassed baseline characteristics, preoperative indications, surgical outcomes, and postoperative complications among patients undergoing liver surgery.</p><p><strong>Results: </strong>Among the included 184 patients (73 standard care, 111 ERAS program), the baseline characteristics were similar. Median postoperative hospital stay differed significantly: 5 days (range: 3-13 days) in ERAS, and 11 days (range: 6-22 days) in standard care (<i>p</i> < 0.001). Prophylactic abdominal drainage was less in ERAS (54.9%) than in standard care (86.3%, <i>p</i> < 0.001). Notably, in ERAS, 88.2% initiated enteral feeding orally on postoperative day 1, significantly higher than in standard care (47.9%, <i>p</i> < 0.001). Early postoperative mobilization was more common in ERAS (84.6%) than in standard care (36.9%, <i>p</i> < 0.001). Overall complication rates were 21.9% in standard care, and 8.1% in ERAS (<i>p</i> = 0.004).</p><p><strong>Conclusions: </strong>Our investigation highlights the merits of ERAS protocol; adherence to its diverse components results in significant reduction in hospital length of stay, and reduced occurrence of postoperative complications, improving short-term recovery post liver resection.</p>","PeriodicalId":72220,"journal":{"name":"Annals of hepato-biliary-pancreatic surgery","volume":null,"pages":null},"PeriodicalIF":1.1,"publicationDate":"2024-08-31","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11341879/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141201319","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}