Published online Oct 27, 2023. doi: 10.4240/wjgs.v15.i10.2191
Peer-review started: May 27, 2023
First decision: June 14, 2023
Revised: June 23, 2023
Accepted: August 17, 2023
Article in press: August 17, 2023
Published online: October 27, 2023
Processing time: 152 Days and 18.7 Hours
Rehabilitation of elderly patients with a high body mass index (BMI) after cholecystectomy carries risks and requires the adoption of effective perioperative management strategies. The enhanced recovery after surgery (ERAS) protocol is a comprehensive treatment approach that facilitates early patient recovery and reduces postoperative complications.
To compare the effectiveness of traditional perioperative management methods with the ERAS protocol in elderly patients with gallbladder stones and a high BMI.
This retrospective cohort study examined data from 198 elderly patients with a high BMI who underwent cholecystectomy at the Shanghai Fourth People's Hospital from August 2019 to August 2022. Among them, 99 patients were mana
The comparison results between the two groups of patients in terms of age, sex, BMI, underlying diseases, surgical type, and preoperative hospital stay showed no statistically significant differences. However, the ERAS group had a significantly shorter preoperative fasting time than the non-ERAS group (4.0 ± 0.9 h vs 7.6 ± 0.9 h). Regarding intraoperative indicators, there were no significant differences between the two groups of patients. However, in terms of postoperative recovery, the ERAS protocol group exhibited significant advantages over the non-ERAS group, including a shorter hospital stay, lower postoperative pain scores and postoperative hunger scores, and higher satisfaction levels. The readmission rate was lower in the ERAS protocol group than in the non-ERAS group (3.0% vs 8.1%), although the difference was not significant. Furthermore, there were significant differences between the two groups in terms of postoperative nausea and vomiting severity, postoperative abdominal distention at 24 h, and daily life ability scores.
The findings of this study demonstrate that the ERAS protocol confers significant advantages in postoperative outcomes following cholecystectomy, including reduced readmission rates, decreased postoperative nausea and vomiting, alleviated abdominal distension, and enhanced functional capacity. While the protocol may not exhibit significant improvement in early postoperative symptoms, it does exhibit advantages in long-term postoperative symptoms and recovery. These findings underscore the importance of implementing the ERAS protocol in the postoperative management of cholecystectomy patients, as it contributes to improving patients' recovery and quality of life while reducing health care resource utilization.
Core Tip: This study compared the effectiveness of the enhanced recovery after surgery (ERAS) protocol with traditional perioperative management methods in elderly patients with gallbladder stones and a high body mass index. The results showed that the ERAS protocol demonstrated significant advantages in postoperative outcomes, including reduced readmission rates, improved postoperative nausea and vomiting, alleviated abdominal distension, and enhanced daily living ability. However, the protocol may not exhibit significant improvement in early postoperative symptoms but demonstrates advantages in long-term symptoms and recovery. Implementing the ERAS protocol in the postoperative management of cholecystectomy patients can contribute to improved recovery and quality of life while reducing health care resource utilization.