Study Of Enhanced Recovery After Surgery In The Perioperative Period Of Re-exploratory Laparotomy Of Biliary Tract

Objective:To explore the application value of enhanced recovery after surgery(ERAS)concept in the perioperative period of re-exploratory laparotomy of biliary tract in intrahepatolithiasis patients.Methods:A total of 100 intrahepatolithiasis patients in department of hepatobiliary surgery of Hunan Provincial People's Hospital from October 2016 to September 2017 were retrospectively analyzed,and all patients were underwent re-exploratory laparotomy of biliary tract.They were divided into ERAS group(n=50)and control group(n=50)according to different therapeutic schedule.Such indexes as postoperative feeding time,anal first exhaust time,postoperative pain score,CRP concentration,liver function recovery,the incidence of postoperative complications,hospitalization time and hospitalization expenses were compared between two groups respectively.Results:A total of 100 patients were collected in this experiment,including ERAS group(n=50)and control group(n=50).The statistical analyses of observed data were.performed between ERAS group and control group.The postoperative feeding time and anal first exhaust time of the ERAS group were ahead of those in control group,the hospitalization time and hospitalization expenses of ERAS group were significantly lower than control group,and all the differences were statistically significant(P<0.05).Compared with control group,the ALT level on the 1st,3rd and 5th day after the operation in ERAS group was lower,and the difference was statistically significant(P<0.05).Moreover,the CRP concentration on the 1st,3rd and 5th day in ERAS group was lower compared to control group,and the difference was statistically significant(P<0.05).In addition,the VAS scores of control group were significantly higher than ERAS group on the lst,2rd and 3rd day after operation,and the difference was statistically significant(P<0.05).However,there was no significant difference between the two groups in TBIL level and DBIL level on the 1st,3rd and 5th day after the operation(P>0.05).The incidence of abdominal distension in ERAS was reduced compared with control group(P<0.05),meanwhile there was no significant difference among other complication(P>0.05).Conclusion:The ERAS project applicated in perioperative period of re-exploratory laparotomy of biliary tract is safe and feasible,which could effectively alleviate postoperative pain,decrease patient's stress response in perioperative period,shorten anal exhaust time after operation and hospitalization time,reduce hospitalization expenses and even lower the incidence of abdominal distension occurring in postoperative.