ERAS protocol in laparoscopic surgery for colonic versus rectal carcinoma: are there differences in short-term outcomes? Med Oncol. 2016;33:56. [PMID: 27154634 DOI: 10.1007/s12032-]

Perioperative application of enhanced recovery after surgery in biliary tract surgery

AIM

To evaluate the safety and clinical effects of enhanced recovery after surgery (ERAS) in the perioperative period of biliary tract surgery.

METHODS

Clinical data for patients who underwent selective biliary surgery at Department of Hepatobiliary Surgery, Affiliated Hospital of Binzhou Medical University from October 2014 to April 2016 were collected. The patients were divided into either a control group (n = 312) to receive traditional perioperative management or an ERAS group (n = 304) to receive fast-track surgical intervention. Each group was divided into subgroups according to the different operative methods used (laparoscopic cholecystectomy, common bile duct exploration and drainage, and cholangioenterostomy) and compared. The differences in preoperative fasting time, indwelling rate and duration of gastric tube and catheter, indwelling duration of abdominal cavity drainage tube, T tube cholangiography time, continuous postoperative ECG monitoring time, postoperative opioid drug use rate, postoperative complications rate, time to first postoperative ambulation, time to first postoperative exhaust, length of hospital stay, and hospitalization expenses as well as the readmission rate and mortality during 30 d after discharge between groups were compared.

RESULTS

Compared with the control group, the ERAS group had significantly shortened preoperative fasting time, decreased indwelling rates of gastrointestinal decompression tube and catheter, shortened indwelling durations of gastrointestinal decompression tube, catheter, and peritoneal cavity drainage tube, shortened time for postoperative T tube cholangiography and duration of postoperative continuous ECG monitoring, decreased postoperative opioid drug use rate, shortened time to postoperative ambulation and exhaust, decreased incidence of postoperative complications, shortened total hospital stay and postoperative hospitalization time, and decreased hospitalization expenses (P < 0.05). No readmission or death was found during 30 d after discharge.

CONCLUSION

The application of ERAS concept and measures in the perioperative period of biliary tract surgery reduces postoperative pain, accelerates the recovery of gastrointestinal function, promotes postoperative early ambulation, reduces the incidence of postoperative complications, shortens hospital stay, decreases the cost of hospitalization, and enhances the early recovery of the patients.