Medicine | 2021

Clinical application of enhanced recovery after surgery in the treatment of choledocholithiasis by ERCP

 
 
 

Abstract


Abstract This study aims to investigate the effect of applying enhanced recovery after surgery methods (ERAS) in perioperative nursing of choledocholithiasis following endoscopic retrograde cholangiopancreatography (ERCP) for treatment of biliary calculus. Clinical data from 161 patients who underwent ERCP surgery in Wuhan Union Hospital from January 2017 to December 2019 were retrospectively analyzed. A total of 78 patients received perioperative nursing using the ERAS concept (experimental group) and 83 patients received conventional perioperative nursing (control group). Group differences were compared for the time to first postoperative ambulation, exhausting time, time to first defecation and eating, intraoperative blood loss, postoperative complication incidence (pancreatitis, cholangitis, hemorrhage), white blood cell (WBC), and serum amylase (AMS) values at 24\u200ahours, duration of nasobiliary duct indwelling, length of hospital stay, and hospitalization expenses. No significant between-group differences were noted for demographic characteristics (age, sex, BMI, ASA score, and comorbidity) (P\u200a>\u200a.05). Time to first ambulation, exhausting time, time to defecation and eating, and nasobiliary drainage time were shorter in the experimental group than the control group, and the differences were statistically significant (P\u200a<\u200a.05). There was no significant between-group difference in postoperative WBC values at 24\u200ahours (P\u200a>\u200a.05), but the experimental group s AMS values at 24\u200ahours postoperation were significantly lower than those of the controls (154.93\u200a±\u200a190.01 vs 241.97\u200a±\u200a482.64, P\u200a=\u200a.031). Postoperative complications incidence was 9.1% in the experimental group, which was significantly lower than the 20.4% in the control group, and this difference was statistically significant (P\u200a=\u200a.039). Compared with the control group, nasobiliary drainage time (26.53\u200a±\u200a7.43\u200ahours vs 37.56\u200a±\u200a9.91\u200ahours, P\u200a<\u200a.001), hospital stay (8.32\u200a±\u200a1.55\u200adays vs 4.56\u200a±\u200a1.38\u200adays, P\u200a<\u200a.001), and hospitalization expenses (36800\u200a±\u200a11900 Yuan vs 28900\u200a±\u200a6500 Yuan, P\u200a=\u200a.016) were significantly lower in the experimental group. ERAS is a safe and effective perioperative nursing application in ERCP for treating choledocholithiasis. It can effectively accelerate patients’ recovery and reduce the incidence of complications; therefore, it is worthy of being applied and promoted in clinical nursing.

Volume 100
Pages None
DOI 10.1097/MD.0000000000024730
Language English
Journal Medicine

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