Application of enhanced recovery after surgery in the treatment of common bile duct stones

Objective To explore the effect and safety of enhanced recovery after surgery (ERAS) in the surgical treatment of common bile duct stones. Methods According to random number table, 48 patients with common bile duct stones were randomly divided into the ERAS group and the control group.The patients of the control group received the traditional perioperative management and laparotomy exploration of common bile duct.The patients of the ERAS group received the ERAS perioperative management and laparoscopic exploration of common bile duct.The preoperative and postoperative level of C reactive protein (CRP), time to out-of-bed activity, time to food taking, time to anal exsufflation, postoperative hospital stay, hospitalization cost and postoperative complications between the two groups were compared. Results Compared with the control group, the ERAS group had lower levels of CRP on the postoperative 1 day and 3 days[d1: (102.6±13.5) mg/L vs.(81.3±17.3)mg/L; d3: (71.8±15.3)mg/L vs.(41.2±11.2)mg/L, t=2.553, 3.287, all P<0.05], had shorter time to out-of-bed activity[(3.2±1.8)d vs.(0.9±0.4)d], time to food taking[(4.3±1.9)d vs.(1.8±1.2)d] and time to anal exsufflation[(2.5±0.7)d vs.(1.2±0.3)d], and had shorter operative hospital stay[(7.3±3.2)d vs.(3.8±1.4)d]and less hospitalization cost[(7 200±800)RMB vs.(5 900±700)RMB] (t=5.561, 4.319, 3.765, 2.351, 1.671, all P<0.05). The incidence rate of postoperative complications of the ERAS group decreased markedly (61.91% vs.18.52%, χ2=25.82, P<0.05). Conclusion ERAS management in the surgical treatment of common bile duct stones is safe and effective, which can enhance the recovery of the patients. Key words: Rehabilitation; Surgical procedures, operation; Laparoscopy