-
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.
-
Early nutritional support for inpatients reduces admission rates to intensive care units in Korea: a single-center case-control study
-
Hyun Suk Kim, Jae Do Yang, Se Wung Han, Mi Rin Lee, Da-Sol Kim, Sejin Lee, Seon-Hyeong Kim, Chan-Young Kim
-
Ann Clin Nutr Metab 2024;16(2):57-65. Published online August 1, 2024
-
DOI: https://doi.org/10.15747/ACNM.2024.16.2.57
-
-
Abstract
PDF
 Supplementary Material
- Purpose: Early nutritional support (ENS) for critically ill patients is promoted by many studies. However, there is a lack of data evaluating its necessity in general wards. This study aims to determine the impact of ENS on patients in general wards.
Methods: Patients aged 18 and above, admitted to the Jeonbuk National University Hospital in Jeonju from January 2020 to December 2020, who were eligible for nutritional support and hospitalized for at least 7 days were included in the study. We divided the patients into two groups: the ENS group, who received nutritional support within 48 hours of admission, and the control group, who received it after 48 hours.
Results: Among 1,077 patients, 146 met the inclusion criteria. The ENS group (n=38) and the control group (n=108) were compared retrospectively. There was a significant age difference between the two groups (P=0.028). The admission ratio to the intensive care unit (ICU) in the ENS group was significantly lower than that in the control group (10.2% vs. 26.3%, P=0.019). The calorie support rate (%) and protein support rate (%) in the ENS group were significantly higher than in the control group (50.12%±23.30% vs. 38.56%±18.02%, P=0.006; 44.61%±25.07% vs. 32.07%±22.76%, P=0.002, respectively). After propensity score matching, the ENS was significantly associated with ICU low admissions (odds ratio 0.08, 95% confidence interval 0.01–0.69, P=0.022).
Conclusion: A future multi-center study considering underlying diseases is needed to provide additional scientific evidence to support the effects of ENS.
-
Physiological Change of Serum Bilirubin Level by ω-3 Enriched Parenteral Nutrition Versus ω-3 Free Parenteral Nutrition in Healthy Male Subjects
-
Mi Rin Lee, Min-Gul Kim, Jae Do Yang, Hong Pil Hwang, Yunjeong Kim, Ji-Young Jeon, Sungwoo Ahn, Hee Chul Yu
-
Surg Metab Nutr 2019;10(1):20-26. Published online June 30, 2019
-
DOI: https://doi.org/10.18858/smn.2019.10.1.20
-
-
Abstract
PDF
-
Purpose: Bilirubin is a biomarker for the diagnosis of liver diseases or bile duct dysfunction. This study assessed the physiological changes in the blood bilirubin level infusing ω-3 enriched parenteral nutrition (PN) and ω-3 free PN in healthy male subjects. Materials and Methods: This study was a randomized, open-label, two-treatment, two-way crossover trial. Sixteen subjects were assigned randomly to one of two sequences of the two treatments: ω-3 enriched PN or ω-3 free PN was infused via aperipheral venous catheter for six hours at 3 mL/kg/h. Blood samples were collected every one hour from 0 to 12 hours after starting an intravenous infusion for bilirubin concentrations. The total bilirubin and direct bilirubin concentrations in the blood were analyzed using an enzymatic method. Results: The bilirubin concentration in the blood was reduced while infusing the ω-3 enriched PN and ω-3 free PN. When it stopped infusing, the bilirubin concentration was recovered. A similar pattern was observed, but there was a further decline and recovery in ω-3 free PN. Conclusion: When ω-3 enriched PN and ω-3 free PN are infused in healthy male subjects, the blood bilirubin level decreasedand there is no difference between the two groups.
|
E-submission
KSPEN
KSSMN
ASSMN
JSSMN
