The effect of a multimodal fast-track programme on outcomes in laparoscopic liver surgery: a multicentre pilot study

Jan H. Stoot*, Ronald M. van Dam, Olivier R. Busch, Richard van Hillegersberg, Marieke De Boer, Steven W. M. Olde Damink, Marc H. Bemelmans, Cornelis H. C. Dejong, ERAS Grp

*Corresponding author for this work

    Research output: Contribution to journalArticleAcademicpeer-review

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    Abstract

    Objectives: This study was conducted to evaluate the added value of an enhanced recovery after surgery (ERAS) programme in laparoscopic liver resections for solid tumours.

    Methods: Patients undergoing laparoscopic liver resection between July 2005 and July 2008 were included. Indications for resections included presumed benign and malignant liver lesions. Primary outcome was total length of hospital stay (LOS). Secondary outcomes were functional recovery, complications, conversions, blood loss and duration of operation.

    Results: Thirteen patients were treated by laparoscopic liver resections in the ERAS programme in one centre (group 1). Their outcomes were compared with outcomes of 13 laparoscopic procedures performed either before the introduction of the ERAS programme during 2003-2005 in the same centre or during the same period in other centres using traditional care (group 2). Median total LOS was 5.0 days (range 3-10 days) in group 1 and 7.0 days (3-12 days) in group 2. This difference was not statistically significant. Functional recovery occurred 2 days earlier in group 1 (median 3.0 days [range 1-7 days] vs. median 5.0 days [range 2-8 days]; P <0.044). There were no significant differences in complications, conversions or duration of operation. Blood loss was significantly less in the ERAS group (median 50 ml [range 50-200 ml] vs. median 250 ml [range 50-800 ml]; P <0.002).

    Conclusions: This exploratory, multicentre, fast-track laparoscopic liver resection study is the first such study conducted. Although small, the study suggests that a multimodal enhanced recovery programme in laparoscopic liver surgery is feasible, safe and may lead to accelerated functional recovery and reductions in LOS.

    Original languageEnglish
    Pages (from-to)140-144
    Number of pages5
    JournalHpb
    Volume11
    Issue number2
    DOIs
    Publication statusPublished - Mar-2009

    Keywords

    • laparoscopic liver surgery
    • functional recovery
    • fast-track surgery
    • multimodal enhanced recovery programme
    • ENHANCED RECOVERY PROGRAMS
    • COLONIC RESECTION
    • CHOLECYSTECTOMY
    • SUCCESS
    • STAY

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