Ann Hepatobiliary Pancreat Surg.  2020 Nov;24(4):477-483. 10.14701/ahbps.2020.24.4.477.

National survey of Korean hepatobiliary-pancreatic surgeons on attitudes about the enhanced recovery after surgery protocol

• Shin SH
• Kang Wh
• Han IW
• You Y
• Lee H
• Kim H
• Jung W
• Shin YC
• Heo JS

• KMID: 2508857
• DOI: http://doi.org/10.14701/ahbps.2020.24.4.477

Abstract

Backgrounds/Aims
The purpose of this study was to investigate attitudes regarding the Enhanced Recovery After Surgery (ERAS) protocol of hepato-biliary-pancreatic (HBP) surgeons in Korea and the extent to which they use the protocol for perioperative management.
Methods
An online survey was conducted among members of the Korean Association of Hepato-Biliary-Pancreatic Surgery (KAHBPS) for eight weeks beginning on August 2019. The questionnaire, which was written in Korean, was based on the latest ERAS guidelines. Total responses were collected from 127 surgeons.
Results
Of the 127 total respondents, the largest proportion (44.9%) were working in Seoul. In terms of established in-hospital clinical pathways (CP), 19.7% of the participating surgeons had and followed a CP in pancreaticoduodenectomy (PD) and 21.3% in hepatectomy. Regarding the ERAS protocol for each surgery, four items (18.2%) regarding PD and seven items (35.0%) related to hepatectomy were followed by more than 50% of respondents.
Conclusions
ERAS guidelines are one of the consensuses for better recovery in perioperative management of patients undergoing major surgeries and encompass the overall process of patient recovery including patient education, pain control, physiologic balance, and perioperative nutrition. A novel project is needed to successfully implement an evidence-based enhanced recovery strategy.

Keyword

ERAS; HBP; Pancreaticoduodenectomy; Hepatectomy

Figure

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  Fig. 1 Personal preferences following enhanced recovery after surgery (ERAS) guideline of pancreaticoduodenectomy. (A) Preoperative biliary drainage, (B) preoperative oral bowel preparation, (C) preoperative fasting, (D) nasogastric intubation, and (E) perianastomotic drain.

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  Fig. 2 Personal preferences following enhanced recovery after surgery (ERAS) guideline of liver surgery. (A) Preoperative nutrition, (B) preoperative fasting, (C) antimicrobial prophylaxis, and (D) prevention of delayed gastric emptying.

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