Abstract: 【Abstract】 Objective The aim of this study was to assess the feasibility and safety of laparoscopic surgery for gastric and duodenal perforation within enhanced recovery after surgery （ERAS） programs. Methods In this retrospective analysis conducted between January 2014 and May 2016，88 consecutive patients diagnosed with gastric and duodenal perforation following laparoscopic surgery were allocated to either ERAS group（N=42）or conventional pathway group（N=46）. The complication，postoperative gastrointestinal function, hospital stay, cost and compliance were evaluated between two groups. Results There were no significant distribution differences of demographics and surgical time between two groups（P>0.05）. Moreover，the incidences of postoperative complication rate were similar between ERAS group and conventional group （9.5% vs 10.9%, P=0.835）. Gastrointestinal recovery parameters such as time to the first flatus（1.8 d vs 2.0 d，P=0.011）and time to the first defecation（2.2 d vs 2.5 d, P=0.018）occurred earlier in ERAS group. The post hospital stay（days）in ERAS and the conventional group were 6.9 d and 7.8 d（P=0.003） respectively. Moreover, the cost （yuan） in the ERAS group was reduced compared to the conventional group （8661.4 vs 9325.7, P=0.044）. In additional, cases in the ERAS group had a shorter stay of gastric tube, abdominal drainage tube and urethral catheter （P<0.05）. Conclusion This study appeared to the feasibility and safety of ERAS protocol in patients with gastric and duodenal perforation undergoing laparoscopic surgery and was associated with a great improvement in postoperative recovery，shorter duration of hospital stay and less cost.

Key words: enhanced recovery after surgery, gastric and duodenal perforation, feasibility, Safety

摘要： 【摘要】目的 本研究旨在探讨围手术期采用加速康复外科（ERAS）理念在腹腔镜治疗胃十二指肠穿孔中的有效性及安全性。方法 回顾性分析2014年1月至2016年5月收治的腹腔镜下治疗胃十二指肠穿孔的患者，将患者根据围手术期处理方法的不同分为2组：ERAS组（42例）和传统组（46例）。分析比较两组患者术后并发症、胃肠功能恢复、住院时间、住院费用及满意程度。结果 两组患者在一般临床资料和手术时间比较无统计学差异。ERAS组和传统组患者在术后并发症发生率比较方面亦未见统计学差异（分别为9.5%和10.9%，P=0.835）。ERAS组的患者术后胃肠功能恢复时间较快，如首次肛门排气时间（分别为1.8天和2.0天，P=0.011），首次肛门排便时间（分别为2.2天和2.5天，P=0.011）。ERAS组和传统组的术后住院时间存在显著差异，分别为6.9天和7.8天（P=0.003）。研究发现ERAS组可显著降低总体的费用（8661.4元和9325.7元，P=0.044）。此外ERAS组患者术后停留胃管、腹腔引流管和尿管的时间亦明显缩短（P<0.05）。结论 本研究的结果显示ERAS概念在胃十二指肠穿孔行腹腔镜治疗的患者中是安全、有效的。ERAS概念可加快术后康复、缩短住院时间、减少手术费用。

关键词: 安全性 , 加速康复外科, 胃十二指肠穿孔, 有效性