A Comparative Study Of Patients Undergoing Laparoscopic Cholecystectomy Guided By The Concept Of Enhanced Recovery After Surgery And The Traditional Concept

Objective:Analysis for postoperative rehabilitation concept and traditional concept of the influence of different age group index after laparoscopic cholecystectomy: through survey guided by the idea of two kinds of different age stages of laparoscopic c holecystectomy in patients with postoperative hospital stay,hospital expenses,comf ort ratings,for the first time after eating time,postoperative bed activity time and complication rates for the first time,statistical analysis,observation of different a ge stages guided by the idea of promoting postoperative rehabilitation in patients with laparoscopic cholecystectomy from traditional concept under the guidance of t he advantage and feasibility of laparoscopic cholecystectomy.Methods:Retrospective analysis was performed on the patients who underwent three-hol e laparoscopic cholecystectomy for chronic cholecystitis,cholecystolithiasis,gallbla dder polyp and other benign diseases in 1 group of general surgery department of shanxi people’s hospital from July 2013 to April 2016.According to age and int ervention measures,the postoperative rehabilitation group(ERAS group n=156)an d the traditional group(n=168)were divided into two groups.Each group was fur ther divided into four age groups according to age and incidence: under 50 years old,50-59 years old,60-69 years old,and over 70 years old.The perioperative p eriod of ERAS group was treated with the unified rehabilitation technique,while t he perioperative period of the traditional group was treated with the traditional tre atment concept.The number of patients with gender,age,disease course and basic diseases(mainly hypertension and diabetes)in each age group of the 2 groups was respectively compared to observe whether there were differences in the basic conditions of the 2 groups and whether there was comparability.The length of po stoperative hospitalization,hospitalization expenses,incidence of complications(incl uding blood,infection,bile leakage,acute pancreatitis,intestinal obstruction,intesti nal leakage,abnormal liver function,etc.),the time of the first postoperative feedi ng,the time of the first postoperative activity,and the 24-hour postoperative comf ort score of the 2 groups were recorded.The postoperative data of 2 groups of p atients of different ages were compared and the conclusions were drawn.Results:A total of 324 patients with benign gallbladder disease were included in th is study,and the proportion of patients at all ages was roughly in line with the p roportion of patients with benign gallbladder disease.Laparoscopic cholecystectom y for benign gallbladder disease is the most common procedure in the 60-69 age group.The rate of underlying diseases increases with age.There was no significa nt difference in gender,age,number of patients with underlying diseases,course of disease,and incidence of postoperative complications between ERAS group and the traditional group at different age stages,and the two groups were comparabl e at different age stages.Postoperative comparison results of patients in the two g roups were as follows: the hospitalization cost,postoperative hospitalization time,first feeding time and first getting out of bed time of patients in the ERAS grou p were all lower than those in the traditional group at the same age,and the co mfort score was higher than those in the traditional group at the same age.In th e age group over 70 years old,the time of the first feeding and the time of the first getting out of bed in the ERAS group were lower than those in the tradition al group at the same age,and the comfort score was higher than those in the tra ditional group at the same age.However,there was no significant difference between hospitalization time and hospitalization cost.The main reason may be that the longer hospitalization time and higher hospitalization cost of patients over 70 yea rs old are related to their own basic diseases,poor surgical tolerance,and their o wn deterioration of body function and slow recovery.Conclusion:Under the guidance of the concept of postoperative rehabilitation,laparoscop ic cholecystectomy can benefit different degrees of patients without increasing the incidence of complications compared with the traditional concept of laparoscopic cholecystectomy.For patients under the age of 70,to promote the postoperative re habilitation concept under the guidance of laparoscopic cholecystectomy than tradit ional concept to guide patients with laparoscopic cholecystectomy can reduce the l ength of hospital stay,reduce hospitalization expenses,to speed up the exhaust,e ating,ambulation time,improve patient comfort during hospitalization,in speeding recovery,hospital stay,comfort,economy benefit patients.For patients over 70 y ears old,laparoscopic cholecystectomy guided by the concept of postoperative reh abilitation can accelerate the time of feeding and getting out of bed,and improve the comfort of patients during hospitalization,compared with that guided by the traditional concept of laparoscopic cholecystectomy.Without reducing the patient’s hospitalization costs and length of stay,patients benefit from accelerated recovery and comfort during hospitalization.