TY - JOUR
T1 - Guidelines for Perioperative Care for Liver Surgery
T2 - Enhanced Recovery After Surgery (ERAS) Society Recommendations 2022
AU - Joliat, Gaëtan Romain
AU - Kobayashi, Kosuke
AU - Hasegawa, Kiyoshi
AU - Thomson, John Edwin
AU - Padbury, Robert
AU - Scott, Michael
AU - Brustia, Raffaele
AU - Scatton, Olivier
AU - Tran Cao, Hop S.
AU - Vauthey, Jean Nicolas
AU - Dincler, Selim
AU - Clavien, Pierre Alain
AU - Wigmore, Stephen J.
AU - Demartines, Nicolas
AU - Melloul, Emmanuel
PY - 2023/1
Y1 - 2023/1
N2 - Background: Enhanced Recovery After Surgery (ERAS) has been widely applied in liver surgery since the publication of the first ERAS guidelines in 2016. The aim of the present article was to update the ERAS guidelines in liver surgery using a modified Delphi method based on a systematic review of the literature. Methods: A systematic literature review was performed using MEDLINE/PubMed, Embase, and the Cochrane Library. A modified Delphi method including 15 international experts was used. Consensus was judged to be reached when >80% of the experts agreed on the recommended items. Recommendations were based on the Grading of Recommendations, Assessment, Development and Evaluations system. Results: A total of 7541 manuscripts were screened, and 240 articles were finally included. Twenty-five recommendation items were elaborated. All of them obtained consensus (>80% agreement) after 3 Delphi rounds. Nine items (36%) had a high level of evidence and 16 (64%) a strong recommendation grade. Compared to the first ERAS guidelines published, 3 novel items were introduced: prehabilitation in high-risk patients, preoperative biliary drainage in cholestatic liver, and preoperative smoking and alcohol cessation at least 4 weeks before hepatectomy. Conclusions: These guidelines based on the best available evidence allow standardization of the perioperative management of patients undergoing liver surgery. Specific studies on hepatectomy in cirrhotic patients following an ERAS program are still needed.
AB - Background: Enhanced Recovery After Surgery (ERAS) has been widely applied in liver surgery since the publication of the first ERAS guidelines in 2016. The aim of the present article was to update the ERAS guidelines in liver surgery using a modified Delphi method based on a systematic review of the literature. Methods: A systematic literature review was performed using MEDLINE/PubMed, Embase, and the Cochrane Library. A modified Delphi method including 15 international experts was used. Consensus was judged to be reached when >80% of the experts agreed on the recommended items. Recommendations were based on the Grading of Recommendations, Assessment, Development and Evaluations system. Results: A total of 7541 manuscripts were screened, and 240 articles were finally included. Twenty-five recommendation items were elaborated. All of them obtained consensus (>80% agreement) after 3 Delphi rounds. Nine items (36%) had a high level of evidence and 16 (64%) a strong recommendation grade. Compared to the first ERAS guidelines published, 3 novel items were introduced: prehabilitation in high-risk patients, preoperative biliary drainage in cholestatic liver, and preoperative smoking and alcohol cessation at least 4 weeks before hepatectomy. Conclusions: These guidelines based on the best available evidence allow standardization of the perioperative management of patients undergoing liver surgery. Specific studies on hepatectomy in cirrhotic patients following an ERAS program are still needed.
KW - Enhanced Recovery After Surgery (ERAS)
KW - Liver Surgery
UR - http://www.scopus.com/inward/record.url?scp=85141000530&partnerID=8YFLogxK
U2 - 10.1007/s00268-022-06732-5
DO - 10.1007/s00268-022-06732-5
M3 - Review article
C2 - 36310325
AN - SCOPUS:85141000530
SN - 0364-2313
VL - 47
SP - 11
EP - 34
JO - World Journal of Surgery
JF - World Journal of Surgery
IS - 1
ER -