Objective: To evaluate the impact of the compound Wuwei ironing pack combined with the ERAS (Enhanced Recovery After Surgery) management protocol on postoperative gastrointestinal recovery in hepatocellular carcinoma patients. Methods: A convenience sampling approach was used to recruit liver cancer patients from the hepatobiliary and pancreatic surgery ward of our hospital between June 2023 and February 2024. A total of 159 patients were randomized into three groups: (1) the control group, which received standard ERAS management; (2) the fennel ironing pack group, which used an independent fennel-based physiotherapy formula; and (3) the compound Wuwei ironing pack group, which utilized a physiotherapy pack developed by the Traditional Chinese Medicine Department. This pack contained five traditional Chinese herbs: fennel, dried tangerine peel, Fructus Aurantii Immaturus, Magnoliae Officinalis Cortex, and malt. The groups were compared based on time to first defecation, length of hospital stay, incidence of infection, and nutritional indicators. Results: The compound Wuwei ironing pack group demonstrated significantly shorter time to first defecation and postoperative hospital stay compared to the fennel group and the control group (both P < 0.05). Conclusion: The compound Wuwei traditional Chinese medicine ironing pack demonstrated better recovery outcomes compared to fennel physiotherapy and standard ERAS management. It reduced hospital stay, is simple to use, safe, and suitable for clinical application.