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Title:           The E-AHPBA—ESSO—Innsbruck consensus recommendations on peri- and postoperative management following liver resection
Subject:         DOI: 10.1093/bjs/znaf272; British Journal of Surgery, 113, 1, 2025-12-29.; Abstract:  Background: Liver surgery carries a high risk of complications due to the complex interplay of patient-related factors, disease characteristics, and liver function. Expertise is essential for healthcare professionals managing hepatobiliary patients. This European consensus provides evidence-based guidance on selected aspects of peri- and postoperative care. Methods: A modified Delphi process was used to achieve consensus, with a 70% agreement threshold. The expert panel comprised hepatobiliary surgeons, anaesthetists, hepatologists, a specialist nurse, and a physiotherapist. A systematic literature search was conducted in PubMed/MEDLINE, Embase, Web of Science, and Cochrane databases. Six topics were addressed: thromboprophylaxis; perioperative antibiotics; prehabilitation/nutrition/mobilization; bile leak including bilioenteric anastomosis leaks; post-hepatectomy haemorrhage; and post-hepatectomy liver failure (PHLF). Evidence appraisal and statement development followed Scottish Intercollegiate Guidelines Network methodology. A patient representative reviewed the guideline. Results: Searching the literature yielded 204 included publications from an initial 6514. Thirty-two statements were formulated with a median evidence level of 2. Evidence strength varied by topic with noticeably lower evidence levels in complex surgery settings and less prevalent conditions. In some topics, study heterogeneity and specific inclusion criteria resulted in conditional recommendations, despite high-level evidence. Notably, the weakest evidence was found for perioperative thromboprophylaxis and PHLF management. Strong recommendations were formulated for prehabilitation, early postoperative mobilization, and avoidance of routine drain use. Several evidence gaps warranting multicentre studies were identified. Conclusion: Optimizing peri- and postoperative care after liver resection remains challeng
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Author:          Eva Maier
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      Title: The E-AHPBA ESSO Innsbruck consensus recommendations on peri- and postoperative management following liver resection
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        Title: Introduction
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       Item: 
        Title: Methods
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         Item: 
          Title: Selection of committee members
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         Item: 
          Title: Selection of key topics to develop in the consensus
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          Title: Methodology for guideline development
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          Title: Inclusion and grading of evidence
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          Title: Validation
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        Title: Results
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       Item: 
        Title: Topic 1: perioperative thromboprophylaxis
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        Title: Topic 2: perioperative antibiotics
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        Title: Topic 3: prehabilitation/nutrition/mobilization
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        Title: Topic 4: post-hepatectomy bile leak including bilioenteric anastomosis leaks
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        Title: Topic 5: PHH
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       Item: 
        Title: Topic 6: PHLF
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        Title: Discussion
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       Item: 
        Title: Funding
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        Title: Disclosure
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        Title: Data availability
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    Title: The E-AHPBA ESSO Innsbruck consensus recommendations on peri- and postoperative management following liver resection
    Author: Eva Maier
    Subject: DOI: 10.1093/bjs/znaf272; British Journal of Surgery, 113, 1, 2025-12-29.; Abstract:  Background: Liver surgery carries a high risk of complications due to the complex interplay of patient-related factors, disease characteristics, and liver function. Expertise is essential for healthcare professionals managing hepatobiliary patients. This European consensus provides evidence-based guidance on selected aspects of peri- and postoperative care. Methods: A modified Delphi process was used to achieve consensus, with a 70% agreement threshold. The expert panel comprised hepatobiliary surgeons, anaesthetists, hepatologists, a specialist nurse, and a physiotherapist. A systematic literature search was conducted in PubMed/MEDLINE, Embase, Web of Science, and Cochrane databases. Six topics were addressed: thromboprophylaxis; perioperative antibiotics; prehabilitation/nutrition/mobilization; bile leak including bilioenteric anastomosis leaks; post-hepatectomy haemorrhage; and post-hepatectomy liver failure (PHLF). Evidence appraisal and statement development followed Scottish Intercollegiate Guidelines Network methodology. A patient representative reviewed the guideline. Results: Searching the literature yielded 204 included publications from an initial 6514. Thirty-two statements were formulated with a median evidence level of 2. Evidence strength varied by topic with noticeably lower evidence levels in complex surgery settings and less prevalent conditions. In some topics, study heterogeneity and specific inclusion criteria resulted in conditional recommendations, despite high-level evidence. Notably, the weakest evidence was found for perioperative thromboprophylaxis and PHLF management. Strong recommendations were formulated for prehabilitation, early postoperative mobilization, and avoidance of routine drain use. Several evidence gaps warranting multicentre studies were identified. Conclusion: Optimizing peri- and postoperative care after liver resection remains challeng
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  Checksum: 1ff10ca2
   Type: CRC32
  Checksum: e9beb06629b20d0d153632288b34b56a
   Type: MD5
  Checksum: eebe6fa50c45ce9aa30920e938eaafc859ff04bd
   Type: SHA-1
  Checksum: 057e3053dc32a1e9df2440f16e7517201c0ed2b183bc13f635774ed37813b62e
   Type: SHA-256