Open versus laparoscopic hepatectomies within an ERAS (Enhanced Recovery After Surgery) program. Are there...

Area of Science:

• Hepatobiliary Surgery
• Minimally Invasive Surgery
• Surgical Outcomes Research

Background:

• Enhanced recovery after surgery (ERAS) programs are increasingly adopted to improve patient outcomes and reduce hospital stays in major abdominal surgeries.
• While ERAS protocols are established for open and laparoscopic hepatectomies, direct comparisons between these approaches within a unified ERAS framework are limited.

Purpose of the Study:

• To directly compare the outcomes of open versus laparoscopic hepatectomies conducted under an identical ERAS program.
• To evaluate the impact of surgical approach on key recovery metrics within a standardized ERAS protocol.

Main Methods:

• A comparative study involving 36 patients undergoing hepatectomy, allocated to either an open or laparoscopic surgical group.
• Both groups adhered strictly to the same enhanced recovery after surgery (ERAS) program.
• Primary endpoints for comparison included hospital stay duration and the incidence of postoperative complications.

Main Results:

• No statistically significant differences were observed in hospital stay duration or complication rates between the open and laparoscopic hepatectomy groups.
• Open surgery demonstrated a trend towards shorter operative times and earlier patient ambulation.
• Laparoscopic hepatectomy was associated with a superior rate of full recovery.

Conclusions:

• Current findings suggest that implementing laparoscopic hepatectomy within an ERAS program does not confer significant advantages over open hepatectomy regarding hospital stay or complication rates.
• The choice between open and laparoscopic hepatectomy within an ERAS program may depend on specific patient factors and desired recovery trajectories, such as speed of ambulation versus overall recovery quality.