A Comparative Study of Different Surgical Techniques in Common Bile Duct Exploration under Protocols of Enhanced Recovery after Surgery
Journal Title: IOSR Journal of Dental and Medical Sciences (IOSR-JDMS) - Year 2018, Vol 17, Issue 6
Abstract
Background:Common bile duct exploration (CBDE), a relatively common procedure for common bile duct patients, includes various techniques of surgical treatment. Enhanced Recovery after Surgery (ERAS) incorporates a number of evidence-based peri-operative interventions to decrease surgical stress, improve postoperative outcomes, and aid recovery enabling decreased length of hospital stay. Objective:The aim of present study was to compare different surgical approaches of CBDE, open/laparoscopic with primary closure/T-tube drainage; after incorporating marginally adjusted principles of ERAS; to see whether different CBDE surgical techniques and drainage methods employed indicate difference in postoperative hospital length of stay and physical activities; and to evaluate the feasibility and safety of ERAS in CBDE. Materials and Methods:In this prospective study a total of 73 common bile duct stone patients undergoing CBDE between August 2016 and December 2017 were included. The study population was compared based on operative approach, open/laparoscopic technique with primary closure/t-tube, after implementation of an adjusted ERAS protocol. Result:The average length of hospital stay was found to be better in laparoscopic approach with primary closure, mean - 5.1 days, when compared to other procedures. Prolonged length of hospital stay was recorded in patients undergoing open surgery, and with t-tube drainage. Statistically significant improvement in physical activities on post-operative day 3 was shown by patients aged 41-55 years when compared to patients aged 71- 85 years old. Conclusion: Laparoscopic approach ensures shorter length of hospital stay in comparison to open procedure with regard to CBDE. Primary choledochotomy closure after CBDE (both open and laparoscopic) results in shorter hospital length of stay when compared with t-tube drainage. Principles of ERAS program can be applied in common bile duct patients with minor adjustments
Authors and Affiliations
Sayyada Orainab Jalal, Mohammed Aameruddin Khan Hashmi, Zijun Liu
Keywords
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- EP ID EP375948
- DOI 10.9790/0853-1706051019.
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