• A Thorell, A D MacCormick, S Awad, N Reynolds, D Roulin, N Demartines, M Vignaud, A Alvarez, P M Singh, and D N Lobo.
• Karolinska Institutet, Department of Clinical Sciences, Danderyds Hospital & Department of Surgery, Ersta Hospital, 116 91, Stockholm, Sweden. anders.thorell@erstadiakoni.se.
• World J Surg. 2016 Sep 1; 40 (9): 2065-83.

BackgroundDuring the last two decades, an increasing number of bariatric surgical procedures have been performed worldwide. There is no consensus regarding optimal perioperative care in bariatric surgery. This review aims to present such a consensus and to provide graded recommendations for elements in an evidence-based "enhanced" perioperative protocol.MethodsThe English-language literature between January 1966 and January 2015 was searched, with particular attention paid to meta-analyses, randomised controlled trials and large prospective cohort studies. Selected studies were examined, reviewed and graded. After critical appraisal of these studies, the group of authors reached a consensus recommendation.ResultsAlthough for some elements, recommendations are extrapolated from non-bariatric settings (mainly colorectal), most recommendations are based on good-quality trials or meta-analyses of good-quality trials.ConclusionsA comprehensive evidence-based consensus was reached and is presented in this review by the enhanced recovery after surgery (ERAS) Society. The guidelines were endorsed by the International Association for Surgical Metabolism and Nutrition (IASMEN) and based on the evidence available in the literature for each of the elements of the multimodal perioperative care pathway for patients undergoing bariatric surgery.

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