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
The rehabilitation of elderly patients with a high body mass index (BMI) after cholecystectomy poses risks and requires effective perioperative management strategies. The enhanced recovery after surgery (ERAS) protocol is a comprehensive treatment approach that promotes early patient recovery and reduces postoperative complications.
The aim of this study was to compare the effectiveness of traditional perioperative management methods with the ERAS protocol in elderly patients with gallbladder stones and a high BMI.
The study aimed to assess and compare the outcomes of elderly patients with a high BMI undergoing cholecystectomy using the ERAS protocol and traditional perioperative care, focusing on various indicators, including fasting time, surgical outcomes, hospital stay, pain scores, satisfaction levels, readmission rates, postoperative symptoms, and functional capacity.
A retrospective cohort study design was employed, involving 198 elderly patients with a high BMI who underwent cholecystectomy. The patients were divided into two groups: One managed using traditional perioperative care (non-ERAS protocol) and the other managed using the ERAS protocol. Data on relevant indicators were collected preoperatively, intraoperatively, and postoperatively, and a comparison of surgical outcomes was conducted.
The comparison results showed no statistically significant differences between the two groups in terms of age, sex, BMI, underlying diseases, surgical type, and preoperative hospital stay. However, the ERAS group had a significantly shorter preoperative fasting time. In terms of postoperative recovery, the ERAS protocol group exhibited significant advantages over the non-ERAS group, including shorter hospital stay, lower postoperative pain scores, hunger scores, and higher satisfaction levels. The readmission rate was also significantly lower in the ERAS protocol group. Furthermore, there were significant differences in postoperative nausea and vomiting (PONV) severity, postoperative abdominal distention at 24 h, and daily life ability scores between the two groups.
The study findings demonstrate that the ERAS protocol provides significant benefits in postoperative outcomes following cholecystectomy. It reduces readmission rates, improves PONV, alleviates abdominal distension, and enhances patients' functional capacity. Although the ERAS protocol may not show significant improvement in early postoperative symptoms, it exhibits advantages in long-term postoperative symptoms and recovery. Implementing the ERAS protocol in postoperative management is crucial for improving patients' recovery and quality of life while reducing health care resource utilization.
The results highlight the importance of incorporating the ERAS protocol in the postoperative management of cholecystectomy patients. Further research can explore the long-term effects of the ERAS protocol on patient outcomes and assess its applicability in other surgical procedures or patient populations.