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01-09-2020 | Laparoscopy | Original Article

The impact of enhanced recovery on open and laparoscopic liver resections

Authors: Francesco Giovinazzo, Christoph Kuemmerli, Alma Moekotte, Arab Rawashdeh, Amal Suhool, Thomas Armstrong, John Primrose, Mohammed Abu Hilal

Published in: Updates in Surgery | Issue 3/2020

Abstract

Enhanced recovery after surgery programs (ERP) have been implemented in many surgical specialties. Their impact in liver surgery is poorly understood and approach-specific ERPs have not yet been assessed. This retrospective study aims to analyse the effect of such programs on liver resection. All patients undergoing liver resection at a tertiary referral centre between January 2009 and April 2019 were identified. Primary outcome was the length of stay (LOS), secondary outcomes were functional recovery, complications and readmission rates. Patients in the ERP with different protocols for open, laparoscopic, major and minor resections were compared to a historical cohort. Of 1056 patients, 644 were treated within the ERP. A comparable duration of hospital stay [7 days (IQR (interquartile range) 6–12) vs 7 days (IQR 5–9) p = 0.047] and faster functional recovery with fewer complications was found in the ERP group [94 (50.5%) vs 103 (35.9%) p < 0.002]. Those advantages were smaller after open minor compared to open major resection. In patients undergoing laparoscopic resection no differences were observed except for a lower readmission rate [21 (9.3%) vs 13 (3.6%) p = 0.005]. Multivariable analysis showed that laparoscopy was associated with a shorter LOS. ERPs offer significant advantages in open liver surgery. Those advantages are less evident after laparoscopic resection.

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Title: The impact of enhanced recovery on open and laparoscopic liver resections
Authors: Francesco Giovinazzo
Christoph Kuemmerli
Alma Moekotte
Arab Rawashdeh
Amal Suhool
Thomas Armstrong
John Primrose
Mohammed Abu Hilal
Publication date: 01-09-2020
Publisher: Springer International Publishing
Keywords: Laparoscopy
Liver Surgery
Liver Resection
Liver Surgery
Liver Resection
Published in: Updates in Surgery / Issue 3/2020
Print ISSN: 2038-131X
Electronic ISSN: 2038-3312
DOI: https://doi.org/10.1007/s13304-020-00786-7

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The impact of enhanced recovery on open and laparoscopic liver resections

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