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. "The protocol's 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.

4th Department of Surgery Medical School Faculty of Health Sciences Aristotle University of Thessaloniki General Hospital George Papanikolaou 57010 Thessaloniki Greece

Department of Anesthesia Resuscitation and Pain Therapy Miguel Servet University Hospital 50009 Zaragoza Spain

Department of Plastic Surgery 2nd Faculty of Medicine Charles University Motol University Hospital 150 06 Prague Czech Republic

Department of Surgery 2nd Faculty of Medicine Charles University Motol University Hospital 150 06 Prague Czech Republic

Department of Surgery Azienda Unità Sanitaria Locale Ferrara University of Ferrara 44121 Ferrara Italy

Department of Surgery Faculty of Medicine University of Zaragoza 50009 Zaragoza Spain

Department of Surgery Universidad Miguel Hernández Elche Hospital General Universitario Elche 03203 Elche Spain

Department of Surgery University Hospital Kralovske Vinohrady 100 34 Prague Czech Republic

Grupo Español de Rehabilitación Multimodal 50009 Zaragoza Spain

Institute for Health Research Aragón 50009 Zaragoza Spain

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