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Erschienen in: Journal of Gastrointestinal Surgery 4/2018

22.12.2017 | Original Article

The Effectiveness of a Clinical Pathway in Liver Surgery: a Case-Control Study

verfasst von: Sander Ovaere, Isabelle Boscart, Isabelle Parmentier, Pieter Jan Steelant, Tino Gabriel, Junior Allewaert, Hans Pottel, Franky Vansteenkiste, Mathieu D’Hondt

Erschienen in: Journal of Gastrointestinal Surgery | Ausgabe 4/2018

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Abstract

Background

In the field of liver surgery, evidence on the effectiveness of clinical pathways based on ERAS principles is limited.

Methods

This is a single-center observational study from a prospectively maintained database. Two cohorts were formed of all patients undergoing liver surgery during a defined period before (traditional management) and after introduction of a clinical pathway. Additionally, a case-match analysis—based on approach, tumor location, and Brisbane classification of resection—was performed. A cost analysis and patient satisfaction questionnaire were carried out.

Results

In both the overall analysis (n = 229) as well as the case-match analysis (n = 100), hospital stay was significantly reduced from 8 to 4 days and from 6.5 to 4 days, respectively (p < 0.05). Postoperative morbidity (traditional management 11/50 vs clinical pathway 5/50; p = 1.00) and readmission rate did not increase. Cost analysis showed a significant decrease in postoperative costs in favor of the clinical pathway (traditional management €3666.7 vs clinical pathway €1912.2; p < 0.001). Overall, 92.3% of the survey questions were answered with satisfied (86.0%) or very satisfied (6.3%).

Discussion

Implementation of clinical pathway for liver surgery is feasible and safe. A clinical pathway significantly reduces hospital stay without increasing postoperative morbidity and readmission rates. Postoperative costs are significantly reduced. Patient satisfaction is high.
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Metadaten
Titel
The Effectiveness of a Clinical Pathway in Liver Surgery: a Case-Control Study
verfasst von
Sander Ovaere
Isabelle Boscart
Isabelle Parmentier
Pieter Jan Steelant
Tino Gabriel
Junior Allewaert
Hans Pottel
Franky Vansteenkiste
Mathieu D’Hondt
Publikationsdatum
22.12.2017
Verlag
Springer US
Erschienen in
Journal of Gastrointestinal Surgery / Ausgabe 4/2018
Print ISSN: 1091-255X
Elektronische ISSN: 1873-4626
DOI
https://doi.org/10.1007/s11605-017-3653-1

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