加速康复外科在精准肝脏外科中的应用

Application of enhanced recovery after surgery in the preci- sion liver surgery

加速康复外科（ERAS）在肝切除术中应用具有安全性和可行性，但相关研究只是沿袭ERAS在结直肠手术中应用的临床策略，并没有涉及肝脏基础疾病的临床处理，更没有突出乙型病毒性肝炎肝硬化对ERAS的影响。安徽省立医院肝脏外科传承ERAS在结直肠手术中临床策略的基础上，聚焦于肝脏基础疾病和特征，经过系统临床探索，提出精准肝脏外科时代ERAS的临床策略。通过多学科团队和医护患的共同努力，在循证医学指导下积极开展多中心临床研究，可能是建立精准肝脏外科时代ERAS临床策略的发展方向。

The application of enhanced recovery after surgery （ERAS） in hepatectomy is safe and feasible. The rela- ted researches of the clinical strategies of ERAS involved in colonic surgery instead of management of basic diseases of liver, and the influence of portal hypertension and hepatitis B virus infection on the ERAS has not been emphasized. According to the clinical strategies of ERAS in colon surgery, the basic diseases and the characteristics of liver were focused, and the clinical strategies of ERAS in the era of precision liver surgery were pro- posed. Through concerted efforts of the muhidisciplinary team and a joint of surgeons, nurses and patients, the establishment of muhicentre clinical studies under guidance of evidence-based medicine （EBM） will show clearly a development direction of the clinical strategies of ERAS in the era of precision liver surgery.