Application of fast track surgery strategy in perioperative period of primary suture of laparoscopic choledocholithotomy / 临床肝胆病杂志

ABSTRACT

ObjectiveTo investigate the clinical application value of fast track surgery strategy (EARS) in the perioperative period of primary suture of laparoscopy in the treatment of common bile duct stones. MethodsA total of 64 patients with gallstones complicated by common bile duct stones who were hospitalized in Department of Hepatobiliary Surgery in The Second People′s Hospital of Chengdu from October 2015 to February 2016 were enrolled, and according to the treatment in the perioperative period, the patients were divided into EARS group (32 patients) and control group (32 patients). Clinical indices and complications were compared between the two groups. The t-test was used for comparison of continuous data between groups, and the chi-square test was used for comparison of categorical data between groups. ResultsCompared with the control group, the ERAS group had significantly shortened time of extraction of drainage tube (1.6±0.9 d vs 2.7±1.0 d, t=-5.675, P＜0.01) and length of hospital stay (5.1±1.0 d vs 6.8±1.1 d, t=-5.910, P＜0.01), significantly shorter time to first ambulation (1.0±0.3 d vs 1.6±0.7 d, t=-4.313, P＜0.01) and time to intestinal functional recovery (1.1±0.4 d vs 1.8±0.6 d, t=-4.842, P＜0.01), a significantly shortened time to stopping infusion after surgery (3.8±1.0 d vs 4.9±1.2 d, t=-3.923, P＜0.01), significantly reduced total hospital costs (17 433.5±1411.3 ten thousand yuan vs 26 651.6±2945.8 ten thousand yuan, t=-15.942, P＜0.001), a significantly lower proportion of patients who experienced pain after surgery ［4 (12.5%) vs 13 (406%), χ2=6.490, P=0.011］, and significantly lower levels of alanine aminotransferase (105.25±35.34 U/L vs 179.00±48.64 U/L, t=-5.973, P＜0.05) and total bilirubin (50.78±12.60 μmol/L vs 79.70±18.56 μmol/L, t=-7.090, P＜0.05) after surgery. ConclusionEARS is highly practical in the perioperative period of laparoscopic surgery and can promote patients′ rapid recovery. Therefore, it holds promise for clinical application.