Summary Background Hepatobiliary (HBI) surgery remains a complex procedure with associated morbidity, despite advancements in surgical techniques and postoperative care. Optimal patient outcomes depend not only on the surgery itself but also on comprehensive preoperative, intraoperative, and postoperative strategies to support patient recovery and mitigate risks. Preoperative optimization, including prehabilitation and lifestyle interventions, has gained attention for its potential to improve surgical outcomes and reduce complications. Methods This review synthesizes the current evidence on different preoperative optimization strategies. Specifically, interventions such as smoking cessation, cardiovascular exercise and weight management as well as dietary and exercise prehabilitation were examined. We also highlight the role of hygienic precautions and infection management in enhancing outcomes. Through a thorough analysis of recent findings, this review aims to establish a comprehensive understanding of accessible and effective preoperative interventions. Results To different degrees, all preoperative interventions showed improved outcomes, including fewer complications, reduced hospital stays and enhanced postoperative quality of life. Conclusion Preoperative patient optimization might improve outcomes after liver resection. Further research is essential to develop standardized protocols for prehabilitation and other optimization measures tailored to the unique needs of HBI patients.
Aitenbichler et al. (Mon,) studied this question.