The ERAS society group for liver surgery recently published the guidelines for ERAS. The final recommendations were validated using the Delphi method. Consensus was reached among experts after 3 rounds. Prophylactic nasogastric intubation and prophylactic abdominal drainage should be omitted. The use of postoperative oral laxatives and minimally invasive surgery results in a quicker bowel recovery and shorter hospital stay. Goal directed fluid therapy with maintenance of a low intraoperative central venous pressure induces faster recovery. Early oral intake and mobilization is recommended. There is no evidence to prefer epidural to other types of analgesia.
The current ERAS recommendations for liver surgery were elaborated based on the best available evidence and endorsed by the Delphi method. Nevertheless, prospective studies need to confirm the clinical use of the suggested protocol.
Access the ERAS guidelines here
Professor Nicolas Demartines
Centre Hospitalier Universitaire Vaudois, Lausanne, Switzerland