Management of fast tract surgery in perioperative period of patients received laparscopic common bile duct exploration

Objective To investigate the effect of management by fast tract surgery (FTS)in perioperative period of laparscopic common bile duct exploration (LCBDE). Methods The perioperative management data of 76 patients who were hospitalized from Mar. 2014 to May 2015 in department of hepatobiliary surgery, the center hospital of Xianyang City and received LCBDE were retrospectively analyzed. All the patients were randomly divided into the FTS group (39 patients) and the routine nursing group (37 patients). Before and after surgery the insulin resistance(IR) index and level of serum C-reactive protein (CRP) were calculated. The indexes such as postoperative times of analgesic medication, first time to anal exsufflation, time for removal of abdominal cavity drainage tube, hospitalization time and total cost, postoperative complications and satisfaction of patients by the third party survey were compared. Results All patients were cured. Their IR and CRP level change trend have been compared from preoperative day to postoperative 7 days, differences wered statistically significant (F=12.93, 17.74, P<0.05); Comparison of two groups of patients after surgery: times of analgesic medication, first time to anal exsufflation, time for removal of abdominal cavity drainage tube, hospitalization time, total cost, with statistically significant differences (t=2.488, 2.165, 14.996, 2.188, 2.183, P<0.05); incidence of postoperative complications wered 15.4% (6/39)and 32.4% (12/37), respectively, showing statistically significant differences (χ2=5.361, P<0.05). Two groups of patients satisfaction survey, respectively, showing statistically significant differences (χ2=6.829, P<0.01). Conclusions The perioperative management by FTS in patients who received LCBDE could alleviate the postoperative stress reaction, reduce the incidence of postoperative complications, accelerate the recovery process, reduce the duration of hospital stay, improve clinical results. Key words: Laparoscopic surgery; Cholelithiasis, common bile duct; Fast tract surgery; Common bile duct exploration; Perioperative management