Application Of ERAS In Treatment Of ERCP Malignant Biliary Obstruction

Objective: The theory of enhanced recovery after surgery（ERAS）is applied to improve the perioperative management of Endoscopic Retrograde Cholangiopancreatography（ERCP）in the treatment of malignant biliary obstruction for the first time.Discuss whether the role of ERAS used in ERCP is safe and whether it can make patients more comfortable,accelerate the recovery and decrease the hospitalization expenses.Methods: The clinical data of 73 patients with malignant biliary obstruction were collected from China-Japan Union Hospital of Jilin University Endoscopy Center from January 2017 to September 2021,divided into ERAS group（n=36）and ordinary treatment group（n=37）according to their perioperative period procedures.These items were comparatively analyzed: the differences of serum amylase,WBC and complications after operation;rates of thirsty,hunger,nausea,vomiting and abdominal pain;the differences of blood pressure and heart rate;the differences of negative emotion,postoperative feeding time,postoperative activity time,hospitalization expenses,length of stay.Measurement data with normal distribution were presented as (3(3 ±S.Comparison between groups were evaluated with an independant sample t test.Count data were analyzed using the chi-square test.Results: The differences of serum amylase at 24 h,WBC at 24 h after operation and complications（pancreatitis,hemorrhage,perforation）were not significant between the ERAS group and conventional group（P>0.05）.The rates of postoperatively thirsty,hunger,nausea,vomiting,abdominal pain,blood pressure and heart rate of ERAS group were lower significantly compared with conventional group（P<0.05）.The negative emotion,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）.Conclusion: Clinical application of enhanced recovery after surgery in treatment for malignant biliary obstruction by ERCP is safe and feasible.ERAS can decrease the rates of postoperatively thirsty,hunger,nausea,vomiting,abdominal pain and negative emotion after operation,make patients more comfortable.ERAS has the advantages of short postoperative feeding and activity time,short hospital stay,less hospitalization expenses and quick recovery.