ERAS in the treatment of cholecystolithiasis complicating extrahepatic bile duct stones by combination of laparoscopy and choledochoscopy / 中华普通外科杂志

ABSTRACT

Objective To evaluate enhanced recovery after surgery (ERAS) in the treatment of cholecystolithiasis complicated with extra hepaticbile duct stones by laparoscopy and choledochoscopy.Methods Patients were divided into ERAS and control groups according to the inclusion and exclusion criteria.Patients in ERAS group received perioperative management according to enhanced recovery rehabilitation program.Clinical and laboratory results were compared between the two groups.Results 46 patients were enrolled into ERAS group and 40 patients into control group.The ERAS group had shorter time of first postoperative exhaust,first postoperative oral intake,getting out of bed,removal of abdominal drainage tube,postoperative hospital stay (respectively t =-3.658,-15.552,-8.864,-6.673,-6.036,all P ＜ 0.05),less pain in 6,12,24 and 48 hours after operation (F =8.284,P =0.000),and lower complication rate (x2 =4.172,P =0.043),lower C-reactive protein (CRP) level from pre-operation to postoperative day 1,3 and 5 (F =6.692,P =0.013),higher level of prealbumin (PA) from preoperation to postoperative day 1,3 and 5 (F =21.191,P =0.000),lower hospitalization costs (t =-0.592,P =0.004).Conclusion The application of ERAS in the treatment of cholecystolithiasis complicated with extrahepatic bile duct stones by laparoscopy combined with choledochoscopy is conducive to rapid postoperative recovery of patients.