Enhanced recovery after surgery combined laparoscopic common bile duct exploration in elderly patients of choledocholithiasis / 中华普通外科杂志

ABSTRACT

Objective To investigate the effects of enhanced recovery after surgery (ERAS) combined with laparoscopic common bile duct exploration (LCBDE) in elderly patients with choledocholithiasis.Methods From Jan 2015 to Dec 2016,in the control group 40 patients received conventional perioperative management and 40 patients in the ERAS group followed the ERAS protocol.The operative details and outcomes were compared in the two groups.Results No perioperative death occurred during the study period.There was no statistically significant difference between the two groups in operative time and intraoperative blood loss (t =1.04,0.88,P ＞0.05).Patients in ERAS group showed significantl shorter time of gastrointestinal tract peristalsis,off-bed,postoperative infusion,food intake,and abdominal drainage tube removal,as well as reduced weight loss,length of hospital stay and total cost than those in the control group (P ＜ 0.05).There were no significant difference of preoperative CRP and PCT,IL-6 in the 2 groups (t =1.18,0.44,1.49,P ＞ 0.05),However,the CRP and PCT,IL-6 levels in ERAS group were significantly lower than those in control group at postoperative days 1,4,7 (P ＜ 0.05).Furthermore,postoperative complications developed in 3 (7.5％),and 12 (30.0％) respectively (x2 =6.47,P ＜ 0.05).Conclusions Minimally invasive surgery combined with ERAS is safe and cost-effective approach for elderly patients of choledocholithiasis.