Enhanced recovery for liver resection—early recovery pathway for hepatectomy: data-driven liver resection care and recovery

First described as a model for perioperative care in the early 1990’s, the success of the enhanced recovery after surgery (ERAS) approach in colorectal surgery has given rise to pathways being developed for an ever-increasing range of surgical specialities/procedures. The fundamental principles of comprehensive patient optimisation combined with minimising the surgical stress response remain at the heart of ERAS and, as evidence for the benefit of this approach continues to emerge, the drive to conduct further research in this area and continue the development of new guidelines grows. Despite this, challenges to achieving a wide-spread uptake of ERAS remain, prominent amongst these being the currently low grade of evidence available for some individual ERAS elements e.g., the use of oral nutritional supplements and early post-operative mobilisation (1). However, the volume and quality of evidence continues to grow with a number of randomised controlled trials (RCTs) and meta-analyses showing favourable results for the use of ERAS programmes in a wide variety of settings. Fewer postoperative complications, reduced hospital length of stay (LoS) and costs, lower readmission rates and improved short and longer-term mortality have all been reported