Enhanced Recovery in Hepatobiliary and Pancreatic Surgery

The Enhanced Recovery Programme in Hepatobiliary and Pancreatic Surgery started in April 2015, concentrating on patients undergoing elective liver resection. Two enhanced recovery care pathways were created, one for patients undergoing laparoscopic liver resection and one for patients undergoing open liver resection.

In January 2019 the Enhanced Recovery Programme expanded to include a new pathway for patients undergoing Pancreatoduodenectomy surgery (Whipples procedure).

Patient information leaflets have been adapted to suit the needs of patients, and the principles of enhanced recovery are included to ensure that patients are aware of their role in their postoperative recovery, including what to expect after the operation.

Patients are encouraged to complete a diary in the days after surgery, so that they can monitor their progress and recovery in line with the enhanced recovery principles of early mobilisation and early nutrition.

Postoperative care pathway

The postoperative care pathways are used to standardise the nursing and medical documentation and to achieve a high quality of postoperative care.

The postoperative pathways detail all aspects of multi-professional care, and set targets for the patient to achieve on each postoperative day, up until discharge from hospital.

Discharge from hospital is based on certain criteria, of which both the patient and the multi-professional team are aware; once these criteria are met, the patient is deemed safe to be discharged from hospital.