Application of enhanced recovery after surgery in the endoscopic retrograde cholangiopancrea-tography treatment for choledocholithiasis in ambulatory surgery ward

Objective To explore the safety and efficacy of enhanced recovery after surgery (ERAS) performed in ambulatory surgery ward for treatment of common bile duct stones (CBDS) using endoscopic retrograde cholangiopancreatography (ERCP). Methods A retrospective analysis was performed concerning two hundred and eleven patients who underwent ERCP surgery for CBDS in the First Affiliated Hospital of Xinjiang Medical University from April 2015 to April 2018. Eighty-five patients who were treated from April 2015 to March 2016 were divided into traditional treatment group (Group T), and 126 patients who were treated from April 2016 to April 2018 were divided into ERAS day care group (Group E). Perioperative period and follow-up status of patients between the two groups were compared and analyzed. Results The first feeding time and the time of getting out of bed in Group E were significantly earlier than that in Group T (P<0.05). The average postoperative hospital stay, medical expenses, thirst/hunger, the incidence of postoperative nausea and vomiting (PONV), the occurrence of abdominal distension and abdominal pain, and the serum amylase level at 3 and 12 h after surgery in Group E were significantly lower than those of Group T (all P<0.05). The satisfaction degree of patients in Group E was (96.66±3.39), which was higher than Group T of (90.25±4.87), with significant difference (t=10.54, P<0.05). The pain scores in Group E were significantly lower (z=-5.12, P<0.05). None of the patients in the two groups were re-admitted within 30 days. There was no significant difference in the incidence of complications and white blood cell count after operation between the two groups. Conclusion It is safe and feasible to treat CBDS with ERCP under ERAS mode in ambulatory surgery ward, which can accelerate the recovery of patients, alleviate postoperative pain and improve satisfaction of patients. Key words: Choledocholithiasis; Enhanced recovery after surgery; Day care; Endoscopic retrograde cholangiopancreatography