Annals of Clinical Nutrition and Metabolism

Guideline

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.

347 View
16 Download

Review Article

Perioperative Nutritional Support: Seung Jong Oh; J Clin Nutr 2021;13(1):7-11. Published online June 30, 2021; DOI: https://doi.org/10.15747/jcn.2021.13.1.7

Abstract PDF: Malnutrition in surgical patients is a prevalent problem. As the geriatric population gradually increases, surgeons need to be more careful in preventing the risk of iatrogenic malnutrition. Delayed wound healing, exposure to infection, pressure sores, gastrointestinal bacterial overgrowth, and immunosuppression in malnourished patients can be prevented or diminished with active nutritional support. Preoperative nutritional assessment and support, as well as adequate postoperative nutrition, will improve surgical outcomes, which in turn will lead to fewer postoperative complications, shorter hospital stays, and lower medical costs. The success of surgery depends not only on technical surgical skills but also on metabolic interventions that take into account the patient’s ability to deliver the metabolic load and provide adequate nutritional support.

764 View
2 Download

First
Prev
Page of 1
Next
Last

Search