The ERAS Era in Bariatric Surgery: A Decade of Transformation
In brief
Bariatric recovery protocols linked to 57% shorter stays and 72% less opioid use
In a single-center study of 250 patients, progressively refined enhanced recovery protocols were associated with shorter hospital stays, less opioid use and more same-day discharges over a decade. Major complications were fewer, but readmissions did not significantly change, and the study was too small to establish safety for uncommon events.
- Journal
- Obesity surgery (Q1)
- Published
- 5 October 2026
- Study design
- Prospective / inception cohort
- Evidence level
- Level 2, Moderate (CEBM 2b)
- Authors
- Talha Zargar, Misbah Jabeen, Mohsin Aijaz Syed, Mubashir A Shah
- PMID
- 42832169
- DOI
- 10.1007/s11695-026-08969-8
Why clinicians should know about it
- Picked for Bariatric and Metabolic Surgery (paper of the day, 6 October 2026).
Abstract
BACKGROUND: Enhanced Recovery After Surgery (ERAS) protocols have transformed perioperative care in bariatric surgery over the past decade. This prospective, single-center study evaluates the implementation, evolution, and impact of ERAS protocols across a 10-year period from 2016 to 2025. METHODS: An observational before-after cohort study using prospectively collected registry data enrolled 250 consecutive patients undergoing laparoscopic sleeve gastrectomy or Roux-en-Y gastric bypass. ERAS protocol elements were progressively implemented and refined. Outcomes included length of stay (LOS), 30-day readmission, opioid consumption, complications, and patient satisfaction (unvalidated VAS). The cohort was divided into two 5-year epochs (2016-2020 and 2021-2025). RESULTS: Mean LOS decreased by 57%, from 2.8 ± 1.2 days to 1.2 ± 0.6 days (p < 0.001). Same-day discharge increased from 12% to 64% (p < 0.001). ERAS compliance improved from 58% to 89% (p < 0.001). Opioid consumption decreased by 72% (p < 0.001). Major complications decreased from 5 events (4.0%) to 2 events (1.6%) (p = 0.04). Thirty-day readmission rates were 3.2% in Epoch 1 versus 2.4% in Epoch 2 (p = 0.68). Patient satisfaction improved from 7.8 to 9.4 (p < 0.001) (unvalidated VAS). CONCLUSION: ERAS protocol maturation was associated with significant reductions in LOS and opioid consumption, improved recovery, and numerically lower major complications. The study was underpowered for uncommon safety outcomes; therefore, findings support feasibility rather than definitive safety claims.
Abstract as published, via PubMed.
For healthcare professionals. The summary is generated by AI from the published abstract, and the evidence level is assigned automatically from the study design on the Oxford CEBM hierarchy. Neither is medical advice. Read the full paper before changing practice.