Open versus laparoscopic hepatectomies within an ERAS (Enhanced Recovery After Surgery) program. Are there differences?

Background: Laparoscopic procedures have gained popularity because they favor a faster recovery. In the same way, the establishment of an enhanced recovery after surgery (ERAS) program in major abdominal surgery has shortened the hospital stay. There are several studies that report the results on ERAS programs applied to open or laparoscopic hepatectomies or comparing one of them with the classic approach but few have compared the results between both within an ERAS program.

Objective: To compare the results between open and laparoscopic hepatectomies in the same ERAS program.

Method: Thirty-six patients undergoing hepatectomies were enrolled in this study and were either laparoscopically or open in an identical ERAS program. Hospital stay and the number of complications were taken as primary end points.

Results: There were no significant differences between both groups in terms of hospital stay or number of complications. The differences were in a shorter time of surgery and an earlier ambulation in favor of open surgery and a better full recovery in favor of the laparoscopic approach.

Conclusions: Initial data suggest that there would be no benefits in terms of hospital stay and complication rate of laparoscopic hepatectomies over open ones within an ERAS program.