Fast-track program for liver resection--factors prolonging length of stay

• Published in: Hepato-gastroenterology Vol. 61; no. 136; p. 2340
• Main Authors: Blind, Per-Jonas, Andersson, Bodil, Tingstedt, Bobby, Bergenfeldt, Magnus, Andersson, Roland, Lindell, Gert, Sturesson, Christian
• Format: Journal Article
• Language: English
• Published: Greece 01.11.2014
• Subjects: Adult; Aged; Aged, 80 and over; Female; Hepatectomy; Humans; Length of Stay; Male; Middle Aged
• ISSN: 0172-6390
• DOI: 10.5754/hge13687

Fast-track programs involving multi-modal measures to enhance recovery after surgery, reduce morbidity and decrease hospital length of stay (LOS) are used for different major surgical procedures. For liver resections, factors influencing LOS within a fast-track program have been studied only to a limited extent, which was the aim of the present study. The present study comprises the first 64 patients included in a fast-track program for liver resections introduced in March 2012. Patient outcomes were compared to a historical cohort of patients (n=62) operated in 2009. Factors prolonging LOS was analyzed by uni- and multivariate analysis. Median LOS was 6 days (range 3-42 days) within the fast-track program as compared with 8 days (range 5-47 days) in the historical cohort (P=0.004). On multivariate analysis, factors increasing LOS in the fast-track group were found to be the presence of complication (P=0.018), extent of resection (major as compared to minor) (P=0.001) and inability to drink > 1250 ml on the day after surgery (P=0.002). Patients who can only drink limited amounts of fluid the day after liver resection represent a subset of patients that should be given special attention within a fast-track program.