Application Of ERAS Concept In Primary Suture Of Laparoscopic Common Bile Duct Exploration

Objective:To investigate the clinical value and social and economic benefits of ERAS by1 aparoscopic common bile duct exploration and primary suture in the treatment of choledocholithiasis.Methods:The test was a prospective study which was utilized to select these patients who were sufferded from diseases of choledocholithiasis combined with gallbladder stone and,from January 2018 to December 2019,were in hospitalized in the Shaoxing Hospital of China Medical University Hospital.These patients were according to different perioperative management randomly divided into two groups : EARS group and the traditional control group.a total of 64 cases were included according to the confirmation criteria,including the ERAS group(n=28 cases)and the traditional control group(n=36 cases).The two groups of patients were compared,by their clinical observation indexes and subsequent complications.The independent sample t-test and chi-square test were respectively adopted to analyze measurement and enumeration data,from statistical aspect.Results: 1.The gender,age,BMI,albumin,diameter of common bile duct and previous basic medical history of the two groups of patients were not statistically significant,P>0.05,which was comparable.2.Comparing the bleeding and operation time between ERAS group and traditional group,there was no evident difference,which showed no statistical significance,P>0.05.3.In terms of postoperative statistical indicators,comparing ERAS group with traditional control group,the exhaust time was earlier[(22.93±4.48)h vs.(32.78±15.89)] h,and the time to get out of bed for the first time after the operation was longer.Early [[23.04±5.09)h vs.(31.58±14.71)] h,shortened hospitalization time [(10.21±2.27)h vs.(12.72±3.01)] h,and reduced hospitalization costs [(17438.57±10308.41)yuan vs.(22173.14±7733.26)] yuan,and the pain scores of1 d,2d and 3d after surgery were lighter([(3.46 ± 0.63)vs(5.55 ± 0.73)],[(1.82 ±0.61)vs(3.52±0.61)],[(0.82±0.60)vs(1.83±0.74)],both were statistically significant,P<0.05.4.The ERAS group compared with the traditional control group,on the occurrence of complications aspect,such as biliary leak,residual stone,pulmonary infection,abdominal cavity bleeding,have no evident difference and no statistical significance,P>0.05.Conclusions:The application of the ERAS in the primary suture of laparoscopic common bile duct exploration is security and effective,does not increase the difficulty of the operation,can speed up the patient’s recovery process,early exhaust,short hospitalization time,low cost,low pain score,and At the same time,it does not increase the possibility and incidence of intraoperative and postoperative complications,and it is worth promoting for patients who need LCBDE+PS.