Impact of Enhanced Recovery after Surgery on Inflammation and Stress Response of Patients Undergoing Laparoscopic Common Bile Duct Exploration T-tube Choledochotomy
LIAO Nan-sheng,ZHANG Yan,WANG Rong-guo
Department of General Surgery and Gastroenterology, Taizhou First People' s Hospital/ Huangyan Hospital Affifiliated to Wenzhou Medical University, Taizhou (318020), China
Abstract:
Objective To observe the impact of enhanced recovery after surgery (ERAS) on inflammation and stress response in patients undergoing laparoscopic common bile duct exploration T-tube choledochotomy. Methods Totally 90 patients with choledocholithiasis in our hospital, from January 2015 to December 2018, were divided into observation group and control group according to random number method, with 45 cases in each group. Abdominal choledocholithotomy and T-tube drainage (laparoscopic cholecystectomy with gallstones) were performed in two groups, the patients in control group were treated with concept of traditional perioperative period, and the patients in observation group were performed under the concept of ERAS. The changes of clinical indexes were observed in two groups, the serum leukocyte (WBC), alanine aminotransferase (ALT), direct bilirubin (DBil), albumin, prealbumin, transferrin, high-sensitivity C-reactive protein (hs-CRP), interleukin (IL)-6, tumor necrosis factor (TNF)-α, renin (PRA), angiotensin-2 (ANG-2) and aldosterone (ALD) were compared on the fifirst day and the fourth day after surgery. Results The fifirst time to get out of bed, anal exhaust time, start eating time, infusion time, T tube clamping time and hospital stay were significantly shorter in the observation group than those in the control group (P<0.01). There were no signifificant differences in serum WBC, ALT, DBil, albumin, prealbumin, transferrin, hs-CRP, IL-6 and TNF-α levels in two groups on the fifirst day after surgery (P>0.05), the levels of WBC, ALT, DBil, hs-CRP, IL-6, TNF-α, PRA, ANG-2 and ALD in two groups on the fourth day after surgery were signifificantly lower than those on the fifirst day after surgery (P<0.01), and the levels of albumin, prealbumin and transferrin in two groups were also signifificantly higher than those on the fifirst day after surgery (P<0.01), while the corresponding indicators on the fourth day after surgery in the observation group were signifificantly lower or higher compared with the control group (P<0.01). Conclusion ERAS can promote the recovery of patients after laparoscopic common bile duct exploration T-tube choledochotomy, promote the recovery of liver function damage, and relieve the body' s inflflammation and stress.
