Annals of Clinical Nutrition and Metabolism

Hae Won Lee

2 Articles

The 2024 Korean Enhanced Recovery After Surgery guidelines for hepatobiliary and pancreatic surgery: Kwangpyo Hong, Hongbeom Kim, Hyung Sun Kim, Hae Won Lee, Ho Joong Choi, YoungRok Choi, Jae Do Yang, Sung-Moon Jeong, Dae Wook Hwang, Do Joong Park, Sang-Jae Park, The Korean Enhanced Recovery After Surgery (ERAS) Committee within the Korean Society of Surgical Metabolism and Nutrition; Ann Clin Nutr Metab 2025;17(3):172-180. Published online December 1, 2025; DOI: https://doi.org/10.15747/ACNM.25.0034

Abstract PDF: Purpose
The Korean Enhanced Recovery After Surgery (ERAS) Committee within the Korean Society of Surgical Metabolism and Nutrition has developed comprehensive guidelines for hepatobiliary and pancreatic (HBP) surgery by adapting established international protocols. These guidelines provide evidence-based recommendations specifically tailored to the Korean healthcare system and address perioperative management for both pancreatoduodenectomy and hepatectomy.
Methods
The HBP subcommittee reviewed existing international ERAS guidelines and conducted an adaptation process. Key questions were identified based on national survey results from Korean HBP surgeons and were prioritized according to clinical relevance. The committee focused on elements supported by moderate- to high-quality evidence with strong recommendation grades. Literature searches were conducted through January 2025, and evidence quality was evaluated using GRADE methodology. Four key questions underwent formal assessment, and eight additional questions were adapted from international guidelines.
Results
Twelve key questions were selected and addressed, covering critical perioperative care domains: prehabilitation, preoperative nutritional assessment and support, anti-thrombotic prophylaxis, prophylactic abdominal drainage, preoperative biliary drainage, smoking and alcohol cessation, pre-anesthetic medication, minimally invasive surgical approaches, prophylactic nasogastric intubation, postoperative glycemic control, perianastomotic drainage management, and early mobilization protocols. Each recommendation was assigned specific evidence levels and graded for strength. High-quality evidence supported strong recommendations for the routine avoidance of prophylactic drainage in uncomplicated hepatectomy, early drain removal after pancreatoduodenectomy in low-risk patients, elimination of routine nasogastric decompression, and the implementation of early mobilization strategies.
Conclusion
These Korean-adapted ERAS guidelines for HBP surgery are expected to standardize perioperative care, reduce postoperative complications, shorten hospital stays, and enhance overall patient outcomes across Korean healthcare institutions.

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Analysis of Compliance and Clinical Outcomes by Expanding Physician’s Departments in Pediatric Nutrition Support Team: Hae Won Lee, Min Jae Jung, Ji Eun Park, Hee Kwon, Jae Song Kim, Hong Go, Eun Sun Son; J Clin Nutr 2019;11(2):42-51. Published online December 31, 2019; DOI: https://doi.org/10.15747/jcn.2019.11.2.42

Abstract PDF: Purpose:
Malnutrition in hospitalized children has an impact on growth, morbidity, and mortality. For this reason, the implementation of pediatric nutrition support team (PNST) has been suggested. On April 2017, in Severance Hospital, more PNST physician’s departments participated in PNST, and a PNST physician assigning system was changed to be the same departments with the attending physician and PNST physician. This study performed a comparative analysis of the compliance and clinical outcomes after expanding the participation of the PNST physician’s department.
Methods:
Pediatric patients, who were referred to a PNST consultant, were divided into two groups: an unmatched group (different departments with the attending physician and PNST physician [154 patients, 233 consultations from May 2016 to October 2016]), and a matched group (same departments with the attending physician and PNST physician [169 patients, 302 consultations from May 2017 to October 2017]). The PNST compliance and clinical outcomes, such as the total delivered/required caloric and protein ratio, % ideal body weight (%IBW), serum total protein, and serum albumin, in the two groups were compared.
Results:
The compliance was significantly higher in the matched group than the unmatched group (63.4% vs. 47.3%, P=0.005). Although there was no significant difference, the total delivered/required caloric and protein ratio, and %IBW in the matched group tended to increase. The serum total protein (0.7±0.7 g/dL vs. –0.4±1.3 g/dL, P=0.004) and serum albumin (0.5±0.5 g/dL vs. –0.1±0.6 g/dL, P=0.003) were significantly higher in the matched group.
Conclusion:
After expanding the physician’s departments in PNST, the compliance was significantly higher in the matched group and the clinical outcomes tended to better. The physician assigning system to be matched with the departments between the attending physician and the PNST physician may help increase the compliance of NST consultations, resulting in an improvement of the patient’s clinical outcomes.

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