Enhanced recovery after surgery in patients undergoing laparoscopic common bile duct exploration: A retrospective study

Medicine (Baltimore). 2022 Aug 26;101(34):e30083. doi: 10.1097/MD.0000000000030083.

Abstract

Few reports have focused on the use of enhanced recovery after surgery (ERAS) in laparoscopic common bile duct exploration (LCBDE) to promote the postoperative recovery of patients with choledocholithiasis. Therefore, this study aimed to explore the advantages and safety of ERAS in patients who underwent LCBDE. From December 2016 to February 2020, 86 and 84 patients were retrospectively enrolled in the control and ERAS groups, respectively. The perioperative insulin resistance index, perioperative C-reactive protein level, time of postoperative analgesic use, time of postoperative first flatus, time of abdominal drainage tube removal, time of liver function recovery, and postoperative complications were analyzed between the two groups. The insulin resistance index (1, 3, and 5 days postoperatively) and C-reactive protein level (1, 3, 5, and 7 days postoperatively) in the ERAS group were significantly lower than those in the control group (all P < .05). In terms of the postoperative rehabilitation efficacy, the time of postoperative activity of the patient, time of postoperative first flatus, time of postoperative analgesic use, time of abdominal drainage tube removal, time of postoperative T-tube closing, and length of postoperative hospital stay in the ERAS group were significantly shorter than those in the control group (all P < .05). Additionally, the overall incidence of postoperative complications in the ERAS group had a decreasing trend when compared with that in the control group (P = .05). ERAS can reduce the postoperative stress response and postoperative complications of patients undergoing LCBDE, promote rehabilitation and shorten the length of postoperative hospital stay and therefore has good social and economic benefits.

MeSH terms

  • C-Reactive Protein
  • Choledocholithiasis* / surgery
  • Common Bile Duct / surgery
  • Enhanced Recovery After Surgery*
  • Flatulence
  • Humans
  • Insulin Resistance*
  • Laparoscopy* / adverse effects
  • Length of Stay
  • Postoperative Complications / epidemiology
  • Postoperative Complications / surgery
  • Retrospective Studies

Substances

  • C-Reactive Protein