Enhanced recovery elements in liver and pancreatic resectional surgery
| Liver resection | Pancreatic resection | |
|---|---|---|
| Preoperatively | Information given to patient and patient education No premedication | Information given to patient and patient education No premedication |
| Day 0 | Normothermia during surgery Mechanical prophylaxis for deep vein thrombosis Intraoperative prophylactic antibiotics No nasogastric tube No routine abdominal drain | Normothermia during surgery Mechanical prophylaxis for deep vein thrombosis Intraoperative prophylactic antibiotics Routine nasogastric and abdominal drain only for Whipple's operation |
| Day 1 | Patient-controlled morphine analgesia Oral fluid Moving patient to chair | Patient-controlled morphine analgesia Oral fluid Moving patient to chair |
| Day 2 | Fluid diet Enhanced mobilisation Removal of urinary catheter | Enhanced mobilisation |
| Day 3 | Soft diet Removal of drain | Removal of urinary catheter Removal of nasogastric tube if draining <300 mL |
| Day 4 | Normal diet | Fluid diet Removal of drain |
| Day 5 | Discharge if no fever, pain can be controlled with oral analgesics and patient has adequate mobilisation | Soft diet |
| Day 6 | Normal diet | |
| Day 7 | Discharge if no fever, pain can be controlled with oral analgesics and patient has adequate mobilisation |