Retrospective Cohort Study
Copyright ©The Author(s) 2023.
World J Gastrointest Surg. Mar 27, 2023; 15(3): 362-373
Published online Mar 27, 2023. doi: 10.4240/wjgs.v15.i3.362
Table 1 Hepatic resection enhanced recovery program after surgery pathway
ERAS item
Preoperative counselingPatients receive dedicated education, full care pathway, details of operation and associated complication, and estimated length of hospital stay with clear verbal and wriinstruction
Preoperative fasting and preoperative carbohydrates loadPreoperative fasting 6 h for solids and 2 h for liquids. Carbohydrate loading evening before the day of surgery and 2 h before induction of anesthesia
Pre-anesthetic anxiolyticShort-acting anxiolytics prior to the induction of anesthesia
VTE prophylaxisLow-molecular weight heparin or unfragmented heparin administration 2-12 h before surgery
Antimicrobial prophylaxis and skin preparationSingle dose intravenous antibiotics administration before skin incision and less than 1 h before hepatectomy
Prophylactic nasogastric intubationNo use of prophylactic nasogastric intubation
Preventing intraoperative hypothermiaMaintenance of perioperative normothermia using forced air blankets and controlling temperature of the operating room
Fluid management (CVP monitoring)The maintenance of low CVP (below 5 cm H2O) with close monitoring during liver transection phase
Prophylactic abdominal drainageNone or minimize the use of prophylactic abdominal drainage
Early mobilizationBegin to walk around the ward at least 3 times a day
Postoperative glycemic controlInsulin therapy to maintain normoglycemia before full oral intake
Preventing PONVPatients should receive PONV prophylaxis with 2 anti-emetic drugs until POD3
Multimodal analgesiaMultimodal analgesia combined with wound infusion analgesia or intrathecal opiates. Removal of epidural analgesia before POD3
Initial oral analgesic drug at POD1Initial oral analgesic drug at POD1
Early NG tube removal at POD1Removal of NG tube at POD1 unless there was > 400 mL/d drainage
Postoperative nutrition and early oral intakePatients can eat soft diet at POD2
Removal of urinary catheter POD2Removal of urinary catheter POD2

  • Citation: Jongkatkorn C, Luvira V, Suwanprinya C, Piampatipan K, Leeratanakachorn N, Tipwaratorn T, Titapun A, Srisuk T, Theeragul S, Jarearnrat A, Thanasukarn V, Pugkhem A, Khuntikeo N, Pairojkul C, Kamsa-Ard S, Bhudhisawasdi V. Compliance with enhanced recovery after surgery predicts long-term outcome after hepatectomy for cholangiocarcinoma. World J Gastrointest Surg 2023; 15(3): 362-373
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