The Clinical Application Of Enhanced Recovery After Surgery(ERAS) Program In The Hepatectomy To Treat Hepatolithiasis

Objective:To investigate the clinical value of Enhanced Recovery After Surgery(ERAS)program in the perioperative period of hepatectomy to treat hepatolithiasis.Methods:From December 2014 to May 2016,81 hepatolithiasis patients at The Second Affiliated Hospital Of Nan Chang University were retrospectively reviewed,all patients were received hepatectomy,patients in ERAS group(n=36)were strictly received ERAS management and the control group(n=45)were received conventional management,The pain score,changes of Inflammatory mediators during perioperative period,postoperative clinical index and postoperative complications were compared between the two groups.Results:The postoperative pain score was significantly lower in ERAS group compared with control group(p<0.05).Levels of PCTat postoperative day 1,4,7 were(2.60±0.46)ng/m L,(2.11±1.17)ng/m L and(1.04±0.56)ng/m L in the ERAS group and(3.78±0.83)ng/m L,(2.98±1.73)ng/m L and(2.06±0.83)ng/m L in the control group,with a significant difference between the 2 groups(P <0.05).Levels of IL-6at postoperative day 1,4,7 were(128.49±15.17)pg/m L,(87.93±10.33)pg/m L and(33.76±7.54)pg/m L in the ERAS group and(264.77±18.25)pg/m L,(195.29±12.71)pg/m L and(95.39±10.88)pg/m L in the control group,with a significant difference of the changing trend between the 2 groups(P <0.05).Levels of CRP at postoperative day 1,4,7 were(40.35±9.78)mg/L,(67.24±6.44)mg/L and(32.19±5.35)mg/L in the ERAS group and(58.36±13.22)mg/L,(100.54±10.77)mg/L and(50.63±8.72)mg/L in the control group,with a significant difference between the 2 groups(P <0.05).Anal exsufflation time were significantly shorter in ERAS group [(34.4±8.7)h vs.(57.7±11.8)h P<0.05],and postoperative hospital stay were significantly shorter in ERAS group [(8.4±2.5)d vs.(11.6±3.3)d P<0.05],but the postoperative complications including surgical wound infection,bile leakage,subdiaphragmatic abscess andabdominal distention were not increased(all P>0.05).Conclusion:The Enhanced Recovery After Surgery(ERAS)program applied to the perioperative management of hepatectomy to treat hepatolithiasis can decreases postoperative pain and stress response,shorten anal exsufflation time and hospital stay,promote postoperative enhanced recovery.