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716). The median time from initial hospital discharge to readmission was 6?days (2�C13). The demographic and preoperative characteristics associated with failure of enhanced recovery protocol are shown in table 2. Of the 137 patients with preoperative indocyanine green test results, 14 (7.2%) were classified as borderline and 4 (2.1%) were poor. There was no significant association between indocyanine green test results and failure groups (p=0.735). Table?2 Demographic and preoperative factors associated with failure of enhanced recovery protocol after major hepatobiliary and pancreatic surgery Ipatasertib price The median duration of hepatic surgery was similar between failure (270?min, 186�C336) and successful enhanced recovery groups (236?min, 180�C315; p=0.348). There was no difference in the median duration of pancreatic surgery between failure (395?min, 192�C641) and successful enhanced recovery groups (488?min, 291�C560; p=0.933). The median Surgical Apgar Score was similar between failure (8, 6�C9) and successful (8, 7�C9) enhanced recovery groups (p=0.912). Elective ICU admissions occurred in 13 (41.9%) patients undergoing laparoscopic liver resection, 19 (23.9%) minor open liver resection, 45 (70.3%) major open liver and/or biliary reconstruction, 15 (88.2%) Whipple and 2 (22.2%) other pancreatic surgery. Of the 94 elective ICU admissions, 17 (18.1%) patients failed enhanced recovery protocols TAK-632 after HBP surgery. Patients with elective ICU admissions were more likely to be enhanced recovery failures than patients sent to the ward after surgery (RRunadjusted=1.49, 95% CI 1.09 to 2.05). The median duration of ICU length of stay was longer in the IWR-1 cell line failure group (25?h, 20�C39) than in the successful enhanced recovery group (19?h, 17�C22; p enhanced recovery groups (p=0.150). The overall incidence of postoperative morbidities was 35.1% (95% CI 28.4% to 42.2%). There was no reported wound dehiscence (requiring surgical exploration or drainage of pus from the operation wound with or without isolation of organisms)17 on the third postoperative day. There was no difference in the incidence of postoperative morbidities between groups according to the a priori Bonferroni correction p value criterion (figure 1). Patients with a postoperative morbidity were twice as likely to be a failure (RRunadjusted=2.36, 95% CI 1.13 to 4.91) than those without. There was no difference in the mean EQ-5D index between failure (0.53��0.3) and successful enhanced recovery groups (0.63��0.29; p=0.166). Figure?1 The incidence of postoperative morbidities on the third day after surgery by enhanced recovery protocol groups. To control for type I error at 0.05 from multiple comparisons, p