Evidence map›Paper›PMID 27549599›Full record

SynthesisWorld journal of surgery2016

Guidelines for Perioperative Care for Liver Surgery: Enhanced Recovery After Surgery (ERAS) Society Recommendations.

Emmanuel Melloul, Martin Hübner, Michael Scott, Chris Snowden, James Prentis, Cornelis H C Dejong, O James Garden, Olivier Farges, Norihiro Kokudo, Jean-Nicolas Vauthey and 2 more

Open access · bronzeAbstract readSystematic Review
PubMed Publisher
In one paragraph

Synthesis in World journal of surgery, 2016. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 255 papers, 20 of them syntheses that pooled it.

0numbers the graph read from it
0cells of the map it votes in
255citing papers in PubMed, 20 pooled it
44.3field-weighted citation impact, top 1% of its field
1 · What the graph read from it

What it found

Each row is one number read from the abstract, on the scale the paper reported it, with its interval. Left of the dashed line favours the treatment, right favours the comparator. Under each row is the sentence it came from. New to these charts? A ten-minute tutorial.

The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.

2 · The registry

The trial behind it

Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.

Neither the registry nor the abstract names a trial number. If this is a trial report, that itself is worth knowing.

3 · Its place in the literature

Who cites it

255 citing papers in PubMed, 20 syntheses or guidelines pooled it, 609 citations in OpenAlex.

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  4. Evaluating the impact of enhanced recovery after surgery protocols following oesophagectomy: a systematic review and meta-analysis of randomised clinical trials.Diseases of the esophagus : official journal of the International Society for Diseases of the Esophagus · 2025
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  6. A meta-analysis of the implementation of enhanced recovery after surgery pathways in anterior cervical spine surgery for degenerative cervical spine diseases.European spine journal : official publication of the European Spine Society, the European Spinal Deformity Society, and the European Section of the Cervical Spine Research Society · 2024
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  19. Enhanced Recovery After Surgery (ERAS) Reduces Hospital Costs and Improve Clinical Outcomes in Liver Surgery: a Systematic Review and Meta-Analysis.Journal of gastrointestinal surgery : official journal of the Society for Surgery of the Alimentary Tract · 2020
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195 more citing papers are in PubMed but not listed here.

4 · The record

Corrections and comments

PubMed lists nothing against this paper. Absence here is not a guarantee, only a check that was made.

5 · Who and what money

Authors and funding

12 authors at 11 institutions in 6 countries.

Emmanuel MelloulDepartment of Visceral Surgery, University Hospital Lausanne, CHUV, Rue du Bugnon 46, 1011, Lausanne, Switzerland.
Martin HübnerDepartment of Visceral Surgery, University Hospital Lausanne, CHUV, Rue du Bugnon 46, 1011, Lausanne, Switzerland.
Michael ScottRoyal Surrey County Hospital NHS Foundation Trust, Guildford, UK.
Chris SnowdenDepartment of Perioperative and Critical Care Medicine, Freeman Hospital, Newcastle upon Tyne, UK.
James PrentisDepartment of Perioperative and Critical Care Medicine, Freeman Hospital, Newcastle upon Tyne, UK.
Cornelis H C DejongDepartment of Surgery, Maastricht University Medical Center and NUTRIM School for Translational Research in Metabolism, Maastricht, The Netherlands.
O James GardenDepartment of Clinical Surgery, School of Clinical Sciences, The University of Edinburgh, Edinburgh, UK.
Olivier FargesDepartment of HPB Surgery and Liver Transplantation, Beaujon Hospital, Clichy, France.
Norihiro KokudoHepato-Biliary-Pancreatic Surgery Division, Department of Surgery, Graduate School of Medicine, The University of Tokyo, Bunkyo-ku, Tokyo, Japan.
Jean-Nicolas VautheyDepartment of Surgical Oncology, U.T. MD Anderson Cancer Center, Houston, TX, USA.
Pierre-Alain ClavienSwiss Hepato-pancreato-biliary and Transplantation Center, Department of Surgery, University Hospital Zurich, Zurich, Switzerland.
Nicolas DemartinesDepartment of Visceral Surgery, University Hospital Lausanne, CHUV, Rue du Bugnon 46, 1011, Lausanne, Switzerland. demartines@chuv.ch.
University of Lausanne · CHFreeman Hospital · GBHôpital Beaujon · FRMaastricht University · NLNewcastle University · GBRoyal Surrey County Hospital · GBThe University of Texas MD Anderson Cancer Center · USThe University of Tokyo · JPUniversity Hospital of Lausanne · CHUniversity Hospital of Zurich · CHUniversity of Edinburgh · GB

Funding

No grant is acknowledged in the PubMed record.

6 · The paper itself

Abstract

backgroundEnhanced Recovery After Surgery (ERAS) is a multimodal pathway developed to overcome the deleterious effect of perioperative stress after major surgery. In colorectal surgery, ERAS pathways reduced perioperative morbidity, hospital stay and costs. Similar concept should be applied for liver surgery. This study presents the specific ERAS Society recommendations for liver surgery based on the best available evidence and on expert consensus.

methodsA systematic review was performed on ERAS for liver surgery by searching EMBASE and Medline. Five independent reviewers selected relevant articles. Quality of randomized trials was assessed according to the Jadad score and CONSORT statement. The level of evidence for each item was determined using the GRADE system. The Delphi method was used to validate the final recommendations.

resultsA total of 157 full texts were screened. Thirty-seven articles were included in the systematic review, and 16 of the 23 standard ERAS items were studied specifically for liver surgery. 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 are recommended. There is no evidence to prefer epidural to other types of analgesia.

conclusionsThe current ERAS recommendations 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.

Indexed as

Perioperative CarePractice Guidelines as TopicDelphi TechniqueHumansLength of StayLiver

Identifiers

PMID27549599
OpenAlexW2292682700

What OpenQuestion holds

Textmetadata
Read underepoch 390

Registered trials

None linked

Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the OpenQuestion graph.