The Impact of Fast-track Perioperative Program After Liver Resection in Hong Kong Chinese Patients

Liver cancer was the third leading cause of cancer death in both sexes in Hong Kong and liver resection remains the mainstay of curative treatment. Post-operative recovery from liver resection has historically been fraught with a high incidence of complications, ranging from 15-48%, and the high incidence of complications leads to prolonged hospital stay, ranging from 9 - 15 days, and increase costs of hospitalization. Recent advancement in the perioperative surgical and anesthetic management of patients undergoing liver resection has led to improvement in these outcomes. The investigators department had previously studied the impact and confirmed the benefit of fast-track peri-operative programs after laparoscopic colorectal surgery. Nevertheless, studies regarding its adoption in liver resection are limited. The investigators group had previously reported, in a retrospective cohort, that successful implementation of ERAS protocol was associated with a significantly shorten hospital stay. However, the peri-operative management in that study incorporated a small proportion of components described in ERAS programs for liver resection and there was no direct comparison with conventional peri-operative program. The aim of this study is to compare the clinical and immunological outcomes of Hong Kong Chinese patients undergoing liver resection for liver cancer with a "conventional" vs a "fast-track" perioperative program.

Sex

All

Minimum age

18 Years

Maximum age

70 Years

Inclusion Criteria:

1. All consecutive patients undergoing elective liver resection (open and laparoscopic).
2. Age of patients between 18 and 70 years.
3. Patients with American Society of Anaesthesiologists (ASA) grading I-II.
4. Patients with no severe physical disability.
5. Patients who require no assistance on the activities of daily living.
6. Informed consent available will be recruited.

Exclusion Criteria:

1. Patients undergoing emergency surgery.
2. Patients who had received pre-operative portal vein embolization.
3. Patients who are expected to receive concomitant procedures other than cholecystectomy.
4. Pregnant ladies and patients who are mentally incapable of written consent will be excluded.
5. Patient who had previous history of Hepato-biliary and pancreatic surgery.
6. Patient who had chronic pain syndrome.