The present systematic review suggests that ERPs in colorectal and pancreas surgery are associated with cost savings compared to conventional perioperative management .
Enhanced recovery programs ( ERPs ) have been shown to improve postoperative outcomes after abdominal surgery .
This study aim ed to review the current literature to assess if ERPs in colorectal , pancreas , and liver surgery induce cost savings .
Implementation of a Fast-Track Clinical Pathway Decreases Postoperative Length of Stay and Hospital Charges for Liver Resection
A fast-track clinical pathway is design ed to streamline patient care delivery and maximize cost effectiveness . It has decreased postoperative length of stay ( LOS ) and hospital charges for many surgical procedures . However , data on clinical pathways after liver surgery are sparse . This study examined whether use of a fast-track clinical pathway for patients undergoing elective liver resection affected postoperative LOS and hospital charges . A fast-track clinical pathway was developed and implemented by a multidisciplinary team for patients undergoing liver resection . Between July , 2007 and May , 2008 , a total of 117 patients underwent elective liver resection :  the fast-track clinical pathway ( education of patients and families , earlier oral feeding , earlier discontinuation of intravenous fluid , no drains or nasogastric tubes , early ambulation , use of a urinary catheter for less than 24 h and planned discharge 6 days after surgery ) was studied prospect ively in 56 patients ( postpathway group ) . These patients were compared with the remainder who had usual care ( prepathway group ) . Outcome measures were postoperative LOS , perioperative hospital charges , intraoperative and postoperative complications , mortality , and readmission rate .  Among all patients , 69 ( 59 % ) had complicating diseases and /or a history of surgery and 24 patients belonged to American Society of Anesthesiologists grade III – IV . Compared with the prepathway group , the postpathway group had a significantly shorter postoperative LOS ( 7 vs. 11 days , P < 0.01 ) . The average perioperative hospital charges were RMB 26,626 for patients in the prepathway group and only RMB 21,004 for those in the postpathway group ( P < 0.05 ) , with no differences in intraoperative and postoperative complications ( P = 0.814 ) , mortality ( P = 0.606 ) , and readmission rate ( P = 0.424 ) . Implementation of the fast-track clinical pathway is an effective and safe method for reducing postoperative LOS and hospital charges for high-risk patients undergoing elective liver resection . The result supports the further development of fast-track clinical pathways for liver surgical procedures
The present systematic review suggests that ERPs in colorectal and pancreas surgery are associated with cost savings compared to conventional perioperative management .
Enhanced recovery programs ( ERPs ) have been shown to improve postoperative outcomes after abdominal surgery .
This study aim ed to review the current literature to assess if ERPs in colorectal , pancreas , and liver surgery induce cost savings .