Abstract:

Implementation of enhanced recovery protocols after hepatobiliary and pancreatic surgery        BAI Xue-li, LI Guo-gang, LIANG Ting-bo.Department of HBP Surgery, the Second Affiliated Hospital, Zhejiang University School of Medicine, Hangzhou 310009,China
Corresponding author:LIANG Ting-bo,E-mail:liangtingbo@zju.edu.cn
Abstract    Enhanced recovery after surgery (ERAS) is a multimodal perioperative care pathway designed to achieve early recovery for patients undergoing major surgery. Its primary aim is to decrease surgery-related stress, complications, and hospital stay, and also to facilitate recovery. The ERAS pathway has been widely applied and approved to be efficient in gastrointestinal surgery, colorectal surgery, thoracic surgery, urology, orthopedics, and gynecology. However, it’s not adapted as a standard of care in hepatobiliary and pancreatic (HBP) surgery patients in China. Most HBP surgeons in China worried that it may put the patients in danger owing to the complexity of surgery procedure and the high incidence of perioperative complications in HBP surgery. In fact, our experiences and other’s studies indicated to the contrary that the ERAS pathway is not only applicable but also very useful in HBP surgery, especially in patients who underwent longer operation and more severe injuries. 

Key words: enhanced recovery after surgery, length of hospital stay after surgery, complication, hepatobiliary and pancreatic surgery

摘要：

术后加速康复（enhanced recovery after surgery，ERAS）是一系列重要的围手术期管理方法的优化整合，以达到减少手术应激反应和并发症的发生，缩短住院日，促进功能恢复。目前，已在胃肠外科、结直肠外科、胸外科、泌尿外科、骨科、妇科等成功应用。与其他外科相比，由于肝胆胰外科手术操作复杂、难度大、并发症发生率高等原因， ERAS尚未能在肝胆胰外科广泛应用。然而，由于肝胆胰外科手术时间长、创伤大，病人应激反应更强，很多临床实践经验表明，肝胆胰外科病人术后同样可以应用和实施ERAS理念和措施。

关键词: 术后加速康复, 术后住院日, 并发症, 肝胆胰外科