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Enhanced recovery after surgery(ERAS)with several evidence-based elements has been shown to shorten length of hospital stay in many operations This randomized clinical trial showed that ERAS protocol is feasible and safe for laparoscopic liver resection It also reduces length of hospital stay in patients with liver cirrhosis Background Enhanced recovery after surgery(ERAS)with several evidence-based elements has been shown to shorten length of hospital stay and reduce perioperative hospital costs in many operations This randomized clinical trial was performed to compare hospital stay of laparoscopic liver resection with ERAS or with standard care Methods A randomized controlled trial was performed for laparoscopic liver resection from August 2015 to August 2016 Patients were randomly divided into ERAS group and standard care group The primary outcome was length of hospital stay(LOS)after surgery Second outcomes included hospital costs postoperative complications and 30-readmissions Elements used in ERAS group included more perioperative education nurse navigators nutrition support for liver cirrhosis respiratory therapy oral carbohydrate 2h before operation early mobilization and oral intake goal-directed fluid therapy and a better pain control Result The study included 56 patients in ERAS group and 58 patients in the standard care group Postoperative LOS was significantly shorter in the ERAS group than standard care group(5 days versus 8 days; p < 0 001)ERAS program significantly reduced the hospital costs(CHY 44303 9 versus 54451 8; p = 0 006)and complications(23 2 versus 41 4 percent; p = 0 047)Duration of first flatus and abdominal drainage were significantly reduced in ERAS group Pain control was better in ERAS(VAS POD1(≥ 4)16 1 versus 37 9 percent; p = 0 011)There was no difference in the rate of 30-days readmissions(1 8 versus 6 9 percent; p = 0 364)Patients with liver cirrhosis in ERAS group had a significantly shorter LOS compared with standard care group(5 days versus 9 days; p < 0 001)Conclusion ERAS protocol is feasible and safe for laparoscopic liver resection It also reduces length of hospital stay in patients with liver cirrhosis Patients in ERAS group have less pain and complications