Application effect of enhanced recovery after surgery on patients with hepatolithiasis undergoing hepatectomy.

Abstract

Objective: To explore the application effect of enhanced recovery after surgery (ERAS) for patients with hepatolithiasis undergoing hepatectomy.

Methods: A retrospective comparative analysis was performed on the clinical data of 120 patients with hepatolithiasis who were admitted to the Department of Hepatobiliary Surgery in our hospital between December 2017 and May 2022 using convenience sampling.

Results: There were differences in the impact of different management modes on blood glucose and visual analogue scale (VAS) scores between the two groups of patients (F_{blood glucose} = 32.581, F_VAS = 41.472, all P < 0.001). The average blood glucose levels in the traditional group were higher than those in the ERAS group at two time points, and the VAS scores in the former group were higher than those in the latter at 6, 12 and 24 h after surgery. The remifentanil dosage (49.89 ± 12.12 vs 57.84 ± 11.43 mL, t = - 2.475, P = 0.016), patient-controlled analgesia frequency (3.83 ± 2.23 vs 5.57 ± 3.52 times, t = - 2.481, P = 0.015) and analgesic supplementation frequency (0.57 ± 0.73 vs 1.07 ± 1.02 times, t = - 2.653, P = 0.010) in the ERAS group were all lower than those in the traditional group. Different management modes had different effects on the levels of procalcitonin (PCT), interleukin-6 (IL-6), C-reactive protein (CRP) and white blood cell count (WBC) in the two groups of patients (F_PCT = 45.371, F_IL-6 = 43.466, F_CRP = 51.364, F_WBC = 65.674, all P < 0.001). The levels of PCT, IL-6, CRP and WBC in the ERAS group were lower than those in the traditional group at three time points: postoperative day 1, 7 and 14. The postoperative hospital stay (8.41 ± 2.55 vs 11.61 ± 3.34 d, t = - 7.812, P < 0.001) and proportion of postoperative complications (9.61% vs 26.47%, χ² = 5.403, P = 0.020) in the ERAS group were lower than those in the traditional group.

Conclusion: The application of ERAS effectively reduces the perioperative stress response, shortens the postoperative length of hospital stay and lowers the overall incidence of postoperative complications in patients with hepatolithiasis.