Clinical Application Of Enhanced Recovery After Surgery In Treatment For Choledocholithiasis By ERCP

Objective: The theory of enhanced recovery after surgery(ERAS)is applied to improve the perioperative management of Endoscopic Retrograde Cholangio-Pancreatography(ERCP)in the treatment of choledocholithiasis for the first time,with adjustments according to the characteristic of ERCP.To evaluate the use of ERASin the treatment for calculus of common bile duct(CBD)by ERCP.Discuss wheter the role of ERAS used in ERCP is safe and wheter it can make patients more comfortable,accelerate the recovery and decrease the hospitalization expenses.Methods: The clinical data of 70 patients with choledocholithiasis were collected from Jilin University Sino-Japanese Friendship Endoscopy Center from December 2015 to January 2017,divided into ERAS group(n=32)and ordinary treatment group(n=38)accroding to their perioperative period procedures.These items were comparatively analyzed: rates of thirsty,hunger,nausea,vomitting and abdominal pain;the differences of serum amylase and WBC after operation;the differences of postoperative feeding time,postoperative activity time,hospitalization expenses,length of stay and complications.Measurement data with normal distribution were presented as `X±S.Comparison between groups were evaluated with an independant sample t test.Count data were analyzed using the chi-square test.Results:The rates of postoperatively thirsty,hunger,nausea,vomiting and abdominal pain of ERAS group were lower significantly compared with conventional group(P <0.05).The postoperative feeding time,postoperative activity time,hospitalization expenses and length of stay of ERAS group were less than that of control group,with significant differences(P<0.05).The differences of serum amylase at 4h and 24 h,WBC at 24 h after operation and complications(pancreatitis,cholangitis,hemorrhage,perforation)were not significant between the ERAS group and conventional group(P>0.05).Conclusion: Clinical application of enhanced recovery after surgery in treatment for choledocholithiasis by ERCP is safe and feasible.ERAS can decrease the rates of postoperatively thirsty,hunger,nausea,vomiting and abdominal pain after operation and make patients more comfortable.ERAS has the advantages of short postoperative feeding and activity time,short hospital stay,less hospitalization expenses and quik recovery.