| OBJECTIVE: To investigate the impact of enhanced recovery after surgery(ERAS)on the prognosis of elderly patients undergoing LCTD for common bile duct stones.METHODS: A total of 96 elderly patients with common bile duct stones(CBDS)who underwent laparoscopic lithotomy in our hospital from January 1,2018 to December31,2019 were selected as the research objects,and divided into observation group(accelerated recovery)50 cases and control group according to different rehabilitation methods Group(routine rehabilitation)46 cases.The basic data of the two groups were collected,and the postoperative recovery,complications,liver function,immune proteins,and inflammatory factor levels were compared with postoperative VAS scores and treatment compliance.RESULTS: The first time to get out of bed after operation,the time to start eating,the abdominal drainage tube was removed earlier than that of the control group,the weight loss,the shorter hospital stay,and the treatment cost were lower in the observation group than in the control group(P<0.05).The number of complications in the observation group was less,and the incidence of complications in the observation group was also lower than that in the control group(P<0.05).Comparison of liver function: Compared with the 1st and 4th days after operation,the levels of ALT,TBIL and DBIL on the 4th postoperative day in the two groups were significantly higher than those on the 1st postoperative day(P<0.05).In comparison,the AST in the observation group on the 1st day after operation was significantly lower than that in the control group(P<0.05),and there was no significant difference in the levels of ALT,TBIL and DBIL between the two groups(P>0.05).On the 4th day after operation,all indexes except DBIL in the observation group were lower than those in the control group(P<0.05).Comparison of inflammatory factor levels.On the 1st and 4th days after operation,the levels of IL-1,IL-6 and CRP in both groups were significantly lower than the preoperative levels,and the decrease was more obvious on the 4th day after operation(P<0.05).There was no significant difference between the two groups on the first postoperative day(P>0.05),but the levels of inflammatory factors in the observation group decreased significantly on the fourth postoperative day(P<0.05).Comparison of VAS scores: The VAS scores of the two groups at 48 h were significantly lower than those at 24h(P<0.05),and the postoperative VAS scores of the observation group were lower than those of the control group at the same time(P<0.05).And the treatment compliance was higher in the observation group than in the control group(P<0.05).CONCLUSIONS: Accelerated rehabilitation to improve the prognosis of elderly patients receiving LCTD for choledocholithiasis is safe and effective,and can significantly improve the patient’s immune function,reduce inflammatory markers,improve patient treatment compliance,and postoperative pain in patients.It should be promoted in clinical practice. |
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