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岭南现代临床外科 ›› 2019, Vol. 19 ›› Issue (05): 533-540.DOI: 10.3969/j.issn.1009-976X.2019.05.005

• 论著与临床研究 • 上一篇    下一篇

快速康复外科策略在肝外胆管结石手术的应用体会

李湧, 吴绍峰, 王付强   

  1. 厦门大学附属中山医院肝胆外科,福建厦门 361004
  • 通讯作者: 李湧

Application of enhanced recovery after surgery in extra-hepatic bile duct stone surgery

LI Yong, WU Shaofeng, WANG Fuqiang   

  1. Department of Hepatobiliary Surgery, Zhongshan Hospital Xiamen University, Xiamen 361004
  • Online:2019-10-20 Published:2019-10-20

摘要: 目的 验证加速康复外科措施在肝外胆管结石手术中应用的安全性、有效性。方法 选取我院2017~2019年因肝外胆管结石拟行腹腔镜胆总管探查患者300例,按照手术时间顺序依次分为ERAS组及对照组,观察比较两组手术时长、术后恶心、呕吐、疼痛强度、肛门首次排气时间、术后尿潴留、并发症(胆汁瘘、胆道狭窄、腹腔感染、切口感染)、术后住院天数等指标。结果 与对照组相比,ERAS组手术时长更短、术后恶心呕吐发生率更低、疼痛程度更轻、肛门排气时间更早、切口感染率更低、术后住院天数更少(P均<0.05),其它手术并发症及术后尿潴留无差异。结论 快速康复外科措施应用在胆总管切开取石手术中,安全、有效,改善患者就医体验。

关键词: 加速康复外科, 肝外胆管结石手术, 安全性, 有效性

Abstract: Objective To verify the safety and effectiveness of enhanced recovery after surgery (ERAS) in extra-hepatic bile duct stone surgery. Methods 300 patients with extra-hepatic bile duct stones undergoing laparoscopic common bile duct exploration in our hospital from 2017 to 2019 were selected and divided into ERAS group and control group according to the sequence of operation time. The duration of operation, nausea and vomiting after operation, pain score, first exhaust time of anus, urinary retention after operation, complications (bile fistula, bile duct stricture, abdominal infection, incision infection) and other indicators were observed. Results Compared with the control group, ERAS group had shorter operation time, lower incidence of nausea and vomiting, less pain, earlier anal exhaust time, lower incision infection rate, fewer hospital days after operation all(P<0.05), and no difference in other surgical complications and urinary retention after operation. Conclusion ERAS in LEBDE is safe and effective, while improve patients′ medical experience.

Key words: effectiveness, safety, enhanced recovery after surgery, laparoscopic common bile duct exploration

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