Enhanced recovery program in liver resection surgery: a single center experience

Background: The enhanced recovery after surgery (ERAS) program promotes postoperative recovery. The study aimed to evaluate the effects of the ERAS protocol in hepatectomy. Methods: The primary outcomes included time to first flatus and length of hospital stay (LOS). Secondary outcomes included time to first passage of stool, time to off-bed activity, pain score, abdominal distension score, postoperative liver function and complications. Outcomes were evaluated between the ERAS group (n=69) and the control group (n=232). A subanalysis of probiotics use in the ERAS group was also performed. Results: In patients undergoing laparoscopic and open hepatectomy, time to first flatus after surgery was significantly shorter, as well as LOS, in the ERAS group. Lower incidence of post-operative complications was noted in ERAS group. While sub-analysis of probiotics group showed no significance in the primary outcomes. Conclusions: Implementation of the ERAS protocol for hepatectomy could significantly promote postoperative recovery. Short-term application of probiotics during the perioperative period did not improve the outcomes in the ERAS group.