Enhanced recovery after surgery combined with clinical pathway management in laparoscopic biliary exploration
10.3760/cma.j.issn.1007-8118.2018.09.008
- VernacularTitle:快速康复外科结合临床路径管理模式在腹腔镜胆道探查术中的应用
- Author:
Guowei LI
1
;
Jianfeng CAI
;
Nianyong YUAN
;
Zusheng YU
;
Qunfeng XIA
;
Wei DING
;
Zhijun LU
;
Jing HE
;
Keying ZHANG
;
Guocan YU
Author Information
1. 311400,浙江省杭州市富阳区第一医院肝胆胰外科
- Keywords:
Clinical pathway management;
Enhanced recovery after surgery;
Laparoscopic biliary exploration
- From:
Chinese Journal of Hepatobiliary Surgery
2018;24(9):604-608
- CountryChina
- Language:Chinese
-
Abstract:
Objective To study the safety,efficacy and advantages of enhanced recovery after surgery (ERAS) combined with clinical pathway management in laparoscopic common bile duct exploration and lithotomy (Laparoscopic common bile duct exploration,LCBDE).Methods 78 patients who underwent LCBDE in the Department of Hepatobiliary and Pancreatic Surgery in the First Hospital of Fuyang District in Hangzhou were selected as the non-ERAS group (the control group).76 patients who underwent LCBDE treated with fast track surgery and ERAS clinical pathway management were selected as the ERAS group.The data between the two groups which included the postoperative insulin resistance index,changes in C-reactive protein,duration of postoperative analgesic use and analgesia,timing of first passage of postoperative flatus,postoperative abdominal tube removal,postoperative bile leakage,recurrence of biliary stones,intestinal ileus and other complications.Results All the two groups were discharged home successfully.On preoperative 7 day,the differences on the postoperative insulin resistance index and the levels of C reactive protein were significantly different (P＜0.05).The time to first get out of bed after operation,the postoperative analgesic use,the time to first passage of flatus,the time to postoperative abdominal drainage tube removal,and the time to clamping of the T tube after operation were significantly different (all P＜0.05).The postoperative complications of pulmonary infection,abdominal infection and the incidence of prolonged intestinal ileus were significantly different (all P＜0.05).Conclusions ERAS combined with clinical pathway management reduced postoperative stress reaction and complication rate.The treatment accelerated recovery and shortened hospital stay for patients who underwent LCBDE,which led to good social and economic benefits.
