Hunan expert consensus on the clinical pathway of enhanced recovery after surgery for hepatobiliary and pancreatic diseases (2026 edition)

Abstract:

To further standardize the implementation of enhanced recovery after surgery (ERAS) in hepatobiliary and pancreatic surgery, the 2022 edition of the Hunan expert consensus on the clinical pathway of enhanced recovery after surgery for hepatobiliary and pancreatic diseases was systematically updated based on implementation experience, newly available national and international evidence from 2022 to 2026, multicenter clinical practice data from Hunan Province, and the resources available at healthcare institutions of different levels. The updated consensus comprises 60 recommendations covering three domains: preoperative, intraoperative, postoperative. Major updates and refinements include frailty assessment and intervention, perioperative sleep management, goal-directed blood pressure and fluid management, standardized intraoperative antimicrobial prophylaxis, risk-stratified management of tubes and drains, post-discharge follow-up, and standardized data collection and artificial intelligence-assisted prediction of postoperative complications. This consensus aims to provide healthcare institutions at different levels with a stratified, measurable, and continuously updatable ERAS clinical pathway for hepatobiliary and pancreatic surgery.