HPB : the official journal of the International Hepato Pancreato Biliary Association
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Both laparoscopic techniques and multimodal enhanced recovery programmes have been shown to improve recovery and reduce length of hospital stay. Interestingly, evidence-based care programmes are not widely implemented, whereas new, minimally invasive surgical procedures are often adopted with very little evidence to support their effectiveness. The present survey aimed to shed light on experiences of the adoption of both methods of optimizing recovery. ⋯ Worldwide dissemination of laparoscopic liver resection is substantial, although laparoscopic volumes are low in the majority of HPB centres. The adoption of enhanced recovery programmes in liver surgery is limited and should be given greater attention.
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Comparative Study
Does pharmacological conditioning with the volatile anaesthetic sevoflurane offer protection in liver surgery?
A recently published randomized control trial (RCT) showed a protection of the remnant liver from ischemia-reperfusion (I/R) injury by pharmacological pre-conditioning with a volatile anaesthetic in patients undergoing hepatic resection. Whether the continuous application of volatile anaesthetics (pharmacological conditioning) also protects against I/R injury is unknown. ⋯ In this retrospective study, continuous volatile anaesthesia in liver resection does not provide protection of the remnant liver from IR injury compared with continuous i.v. anaesthesia.