{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,5,20]],"date-time":"2026-05-20T10:10:21Z","timestamp":1779271821185,"version":"3.51.4"},"reference-count":64,"publisher":"MDPI AG","issue":"6","license":[{"start":{"date-parts":[[2025,5,26]],"date-time":"2025-05-26T00:00:00Z","timestamp":1748217600000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"funder":[{"name":"Erasmus + Programme of the European Union","award":["2020-1-ES01-KA203-082681"],"award-info":[{"award-number":["2020-1-ES01-KA203-082681"]}]}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":["Medicina"],"abstract":"<jats:p>Hepatectomies play a crucial role in the multidisciplinary management of primary and secondary liver malignancies but are associated with significant risks, including 30-day mortality, morbidity, prolonged hospitalization, and increased resource utilization. Optimizing perioperative care remains a challenge; however, enhanced recovery programs have shown improved patient outcomes. The EUPEMEN (EUropean PErioperative MEdical Networking) protocol focuses on improving the perioperative management of liver resections through the establishment of interdisciplinary principles based on practical experience and theoretical frameworks from five European countries. This paper outlines the core elements of the EUPEMEN protocol, emphasizing strategies to minimize surgical stress, optimize perioperative care, and enhance postoperative recovery. The protocol is systematically designed to reduce postoperative mortality and morbidity, shorten hospital stays, and improve patient outcomes. The EUPEMEN guidelines address inconsistencies in surgical practice across Europe and are structured for implementation in various healthcare environments. \u201cThe protocol\u2019s approach is designed to support improvements in perioperative care standards in liver resections and may serve as a practical and efficient tool for healthcare professionals, pending further clinical validation. The EUPEMEN protocol offers a standardized, evidence-based framework to enhance perioperative management in hepatectomies. By integrating multidisciplinary principles, the main target is to eliminate complications, improve surgical outcomes, and promote faster recovery. Its implementation across diverse clinical settings may contribute to advancing perioperative care standards for liver resections in Europe.<\/jats:p>","DOI":"10.3390\/medicina61060978","type":"journal-article","created":{"date-parts":[[2025,5,29]],"date-time":"2025-05-29T07:46:26Z","timestamp":1748504786000},"page":"978","update-policy":"https:\/\/doi.org\/10.3390\/mdpi_crossmark_policy","source":"Crossref","is-referenced-by-count":5,"title":["Recommendations for Perioperative Care in Liver Resection: The EUPEMEN (EUropean PErioperative MEdical Networking) Protocol"],"prefix":"10.3390","volume":"61","author":[{"ORCID":"https:\/\/orcid.org\/0000-0002-0861-8783","authenticated-orcid":false,"given":"Orestis","family":"Ioannidis","sequence":"first","affiliation":[{"name":"Fourth Department of Surgery, Medical School, Faculty of Health Sciences, Aristotle University of Thessaloniki, General Hospital \u201cGeorge Papanikolaou\u201d, 57010 Thessaloniki, Greece"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-5741-2071","authenticated-orcid":false,"given":"Aggeliki","family":"Koltsida","sequence":"additional","affiliation":[{"name":"Fourth Department of Surgery, Medical School, Faculty of Health Sciences, Aristotle University of Thessaloniki, General Hospital \u201cGeorge Papanikolaou\u201d, 57010 Thessaloniki, Greece"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-5650-7319","authenticated-orcid":false,"given":"Elissavet","family":"Anestiadou","sequence":"additional","affiliation":[{"name":"Fourth Department of Surgery, Medical School, Faculty of Health Sciences, Aristotle University of Thessaloniki, General Hospital \u201cGeorge Papanikolaou\u201d, 57010 Thessaloniki, Greece"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-7964-1166","authenticated-orcid":false,"given":"Jose M.","family":"Ramirez","sequence":"additional","affiliation":[{"name":"Institute for Health Research Arag\u00f3n, 50009 Zaragoza, Spain"},{"name":"Department of Surgery, Faculty of Medicine, University of Zaragoza, 50009 Zaragoza, Spain"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-7039-3717","authenticated-orcid":false,"given":"Nicol\u00f2","family":"Fabbri","sequence":"additional","affiliation":[{"name":"Department of Surgery, Azienda Unit\u00e0 Sanitaria Locale Ferrara, University of Ferrara, 44121 Ferrara, Italy"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Javier Mart\u00ednez","family":"Ubieto","sequence":"additional","affiliation":[{"name":"Institute for Health Research Arag\u00f3n, 50009 Zaragoza, Spain"},{"name":"Department of Anesthesia, Resuscitation and Pain Therapy, Miguel Servet University Hospital, 50009 Zaragoza, Spain"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-0699-5689","authenticated-orcid":false,"given":"Carlo Vittorio","family":"Feo","sequence":"additional","affiliation":[{"name":"Department of Surgery, Azienda Unit\u00e0 Sanitaria Locale Ferrara, University of Ferrara, 44121 Ferrara, Italy"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-7560-551X","authenticated-orcid":false,"given":"Antonio","family":"Pesce","sequence":"additional","affiliation":[{"name":"Department of Surgery, Azienda Unit\u00e0 Sanitaria Locale Ferrara, University of Ferrara, 44121 Ferrara, Italy"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Kristyna","family":"Rosetzka","sequence":"additional","affiliation":[{"name":"Department of Plastic Surgery, Second Faculty of Medicine, Charles University, Motol University Hospital, 150 06 Prague, Czech 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Republic"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-0623-9074","authenticated-orcid":false,"given":"Luis","family":"S\u00e1nchez-Guill\u00e9n","sequence":"additional","affiliation":[{"name":"Department of Surgery, Universidad Miguel Hern\u00e1ndez Elche, Hospital General Universitario Elche, 03203 Elche, Spain"},{"name":"Grupo Espa\u00f1ol de Rehabilitaci\u00f3n Multimodal (GERM), 50009 Zaragoza, Spain"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-9440-8282","authenticated-orcid":false,"given":"Ana Pascual","family":"Bellosta","sequence":"additional","affiliation":[{"name":"Institute for Health Research Arag\u00f3n, 50009 Zaragoza, Spain"},{"name":"Department of Anesthesia, Resuscitation and Pain Therapy, Miguel Servet University Hospital, 50009 Zaragoza, Spain"},{"name":"Grupo Espa\u00f1ol de Rehabilitaci\u00f3n Multimodal (GERM), 50009 Zaragoza, Spain"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-4415-172X","authenticated-orcid":false,"given":"Adam","family":"Whitley","sequence":"additional","affiliation":[{"name":"Department of Surgery, University Hospital Kralovske Vinohrady, 100 34 Prague, Czech Republic"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Alejandro Bona","family":"Enguita","sequence":"additional","affiliation":[{"name":"Institute for Health Research Arag\u00f3n, 50009 Zaragoza, Spain"},{"name":"Grupo Espa\u00f1ol de Rehabilitaci\u00f3n Multimodal (GERM), 50009 Zaragoza, Spain"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Marta","family":"Teresa-Fernand\u00e9z","sequence":"additional","affiliation":[{"name":"Institute for Health Research Arag\u00f3n, 50009 Zaragoza, 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Greece"}],"role":[{"role":"author","vocabulary":"crossref"}]}],"member":"1968","published-online":{"date-parts":[[2025,5,26]]},"reference":[{"key":"ref_1","doi-asserted-by":"crossref","first-page":"119","DOI":"10.4097\/kja.d.19.00010","article-title":"Enhanced recovery after surgery in liver resection: Current concepts and controversies","volume":"72","author":"Agarwal","year":"2019","journal-title":"Korean J. 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