JOURNAL OF CLINICAL SURGERY ›› 2020, Vol. 28 ›› Issue (7): 669-672.doi: 10.3969/j.issn.1005-6483.2020.07.021

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The influence of fast tract surgery on postoperative recovery and stress reaction for laparoscopic common bile duct exploration and primary suture

  

  1. Department of Hepatobiliary Surgery,Chongqing People's Hospital,University of Chinese Academy of Sciences,Chongqing 401121,China
  • Online:2020-07-20 Published:2020-07-20

Abstract: Objective To analyze the effect of enhanced recovery after surgery(ERAS)procedures on recovery and stress response in patients undergoing laparoscopic common bile duct exploration and primary suture(LBEPS).
Methods Retrospective analysis of 60 patients with the LBEPS in Chongqing People’s Hospital from May 2016 to April 2019.According to the rehabilitation method,it was divided into intervention group(n=30)and control group(n=30).The intervention group adopted the concept of ERAS for perioperative management,and the control group was managed according to the routine method.The time to get out of bed,anal exhaust time,eating time,length of stay,hospital costs,postoperative complications,and interleukin-6(IL-6),C-reactive protein(CRP),and white blood cell count(WBC)on day 1st,3rd,and 5th before and after surgery were compared between the two groups.
Results Both groups completed the operation successfully.There was no significant difference in general data between the two groups(P>0.05).In the intervention group,the time of getting out of bed,exhaust and eating were earlier,the time of hospitalization was shorter and the cost of hospitalization was lower.The incidence of postoperative complications(26.7% vs.50%)was lower than that of the control group,and the analgesic effect was better,with statistically significant differences(P<0.05).On the first,third and fifth days after surgery,IL-6 and CRP in the intervention group were lower than those in the control group,respectively(80.05±27.84)μg/L vs.(191.47±118.26)μg/L,(52.78±33.28)μg/L vs.(112.98±63.89)μg/L,(18.11±8.20)μg/L vs.(55.80±38.62)μg/L,(30.46±16.37)mg/L vs.(56.38±38.12)mg/L,(80.05±27.84)mg/L vs.(113.88±68.44)mg/L,(43.60±22.49)mg/L vs.(66.59±〖LM〗35.72)mg/L,the difference were statistically significant(P<0.05).
Conclusion The  concept of the ERAS to patients with the LBEPS can reduce postoperative stress response,reduce postoperative complications,and accelerate rehabilitation of patients.

Key words: fast tract surgery, laparoscopy operation, primary closure, stress reaction

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