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Enhanced Recovery After Surgery: Hepatobiliary.

Heather A Lillemoe1, Thomas A Aloia1

  • 1Department of Surgical Oncology, The University of Texas MD Anderson Cancer Center, Houston, TX, USA.

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Summary

Enhanced recovery after surgery (ERAS) pathways improve patient care across surgical fields. This article highlights ERAS specifics for hepatopancreatobiliary surgery, including outcomes and costs.

Keywords:
ERASEnhanced recoveryFast-trackHepatectomyHepatobiliary surgeryPancreatectomyPatient-reported outcomesRIOT

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Area of Science:

  • Perioperative Medicine
  • Surgical Outcomes
  • Evidence-Based Practice

Background:

  • Enhanced Recovery After Surgery (ERAS) pathways are multidisciplinary, evidence-based protocols.
  • ERAS has demonstrated positive outcomes, leading to its adoption in various surgical subspecialties.
  • Hepatopancreatobiliary (HPB) surgery presents unique considerations for ERAS implementation.

Purpose of the Study:

  • To detail the specific applications of ERAS pathways within hepatopancreatobiliary surgery.
  • To emphasize unique aspects of ERAS relevant to HPB procedures.
  • To discuss less frequently addressed elements of ERAS, such as patient-reported outcomes, recovery assessment, cost, and auditing.

Main Methods:

  • Review of existing literature and clinical guidelines on ERAS protocols.
  • Identification of universal ERAS components and those specific to HPB surgery.
  • Inclusion of discussions on patient-reported outcomes, recovery metrics, economic impact, and quality auditing.

Main Results:

  • ERAS pathways are adaptable and beneficial across surgical disciplines.
  • Specific modifications to ERAS are necessary for the complexities of HPB surgery.
  • Comprehensive assessment of ERAS includes patient experience, efficiency, and financial implications.

Conclusions:

  • ERAS protocols offer significant advantages in perioperative care for HPB surgery.
  • Tailoring ERAS to HPB surgery requires attention to specialized needs.
  • Further investigation into patient-reported outcomes, cost-effectiveness, and auditing is crucial for optimizing ERAS in HPB surgery.