Application Of Fast Track Surgery In Treating Extrahepatic Bile Duct Stones And Efficacy Analysis

Background and purpose:Fast track surgery(fast track surgery,FTS),also called it as fast track surgery(enhanced recovery after surgery,ERAS),is defined according to perioperative physiology,pathology,through the application of evidence-based medicine proven effective method,minimize the stress response and organ dysfunction patients in order to achieve reduction of complications,accelerated postoperative rehabilitation.Among them,the fast track surgery minimally invasive surgery is the concept of core areas.After years of research and clinical practice,FTS many concepthas been widely used and have been successful in the treatment of many clinical diseases.Cholelithiasis as hepatobiliary surgery clinical common disease,its incidence is increasing year by year.According to the site where the stones cholelithiasis can be divided into: gallstones,intrahepatic and extrahepatic bile duct stones bile duct stones.Among them,the extrahepatic bile duct stones include in the hepatic duct,cystic duct and common bile duct stones section.Extrahepatic bile duct stones in the choice of treatment,due to the distribution of biliary stones vary,stone size and number are variable,depending on the circumstances of the patient reasonable treatment options,is every biliary surgeon must face.Currently,surgery is the treatment of common bile duct extrahepatic bile duct stones most popular and effective approach,including open choledochotomy + T tube drainage(OCHTD)and laparoscopic common bile duct exploration(LCBDE),which combined with intraperitoneal LCBDE Features biliary mirror and mirror,fully embodies the advantages of minimally invasive.In recent years the development of minimally invasive techniques is to treat extrahepatic bile duct stones brought many new ideas.Traditional operation,the laparoscopic common bile duct exploration joint cholangioscopy + T tube drainage(LCHTD)is one of the largest clinical application procedure,and its efficacy has been widely affirmed.However,patients need long-term postoperative T tube carrying,seriously affecting the quality of life of patients,and bring many complications occur,the patient is not actually recovered state,after two T tube removal required hospitalization for the patient's psychological and economic situation again It is no small burden.Compared to this,laparoscopy combined cholangioscopy cystic duct stone(LTCBDE)The operative has a great advantage,both to ensure the treatment effect,to avoid the trauma caused by the common bile duct,but also reduces the bile the possibility of fistula,but its application should be strictly grasp the indications,is not widely used.Laparoscopic common bile duct suture without T tube placed under strict control application testify case proved to be safe and effective.Among them,laparoscopy,biliary mirror,duodenum(a three-mirror choledochal suture merger ENBD drainage,but with a wider range ofapplications and advantages to testify.Endoscopic retrograde cholangiopancreatography + endoscopic sphincterotomy stone extraction(ERCP + EST)technology is one of the more popular another clinical application of technology,which is less invasive,quick recovery,but in recent years with people for duodenal sphincter in-depth study,to protect the normal sphincter function nipple,get everyone's wide attention.and high ERCP / EST postoperative complication rate,the occurrence of bleeding,perforation,acute pancreatitis,cholangitis and other complications will bring patients greater pain.So,FTS joint idea whether micro-surgical technique can be more efficient and innovative security? Based on the above background,this paper aims to analyze the concept of fast track surgery in the treatment of bile duct stones safety and effectiveness extrahepatic.Methods Retrospective analysis of hospital treatment and the effect of bile duct stones in patients admitted from January 2012 to December 2015 123 cases of liver,the 60 patients from January 2012 to September 2013 as a control group,using the traditional perioperative management philosophy;from October 2013 to December 2015 63 patients as a quick recovery(FTS)group,the application of rapid rehabilitation concept.Analysis and comparison of postoperative ambulation,oral feeding time,first exhaust defecation time,hospitalization time,cost of hospitalization,incidence of postoperative complications,the feasibility of application of fast track surgery in treating extrahepatic bile duct stones and effectiveness.Results FTS group compared with the control group,the hospital stay was significantly shorter(P <0.05),hospital costs reduced(P <0.05),reduce the incidence of postoperative complications(P <0.05).Conclusions Application of Fast track surgery in treating extrahepatic bile duct stones,can effectively shorten the length of hospital stay,cost of hospitalization of patients,reduce the incidence of postoperative complications,it is safe and effective.