Effectiveness of enhanced recovery after surgery in elderly hepatolithiasis patients after partial hepatectomy

老年肝内胆管结石患者行部分肝切除术后加速康复的有效性

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Abstract

OBJECTIVE: Enhanced Recovery After Surgery (ERAS) aims to reduce patients' stress response during the perioperative period through a series of evidence-based optimization measures, promoting rapid rehabilitation. This study aimed to evaluate the effectiveness and safety of ERAS in this high-risk group, with particular attention to the recovery of liver function, gastrointestinal function, and postoperative complications, all of which are critical to improving outcomes in elderly patients and have not been thoroughly investigated in previous studies. METHODOLOGY: The clinical data of elderly patients with hepatolithiasis who underwent partial hepatectomy in Hunan Provincial People's Hospital from October 2022 to October 2024 were retrospectively analyzed. Patients were divided into the ERAS and the control groups according to whether they received ERAS during the perioperative period. The perioperative indexes, liver function indexes, and complications were compared between the two groups. RESULTS: A total of 141 patients met the inclusion criteria: 73 patients in the ERAS group and 68 patients in the control group. After operation, the first exhaust time and postoperative hospital stay in the ERAS group were significantly lower than in the control group (P<0.05). Five days after the operation, levels of aminotransferase (ALT) in the ERAS group were significantly lower, and albumin (ALB) levels were significantly higher than those in the control group (all P<0.05). ERAS was associated with considerably lower total number of postoperative complications (P<0.05). CONCLUSIONS: The application of the ERAS concept in the perioperative period of partial hepatectomy in elderly patients with hepatolithiasis is safe and effective.

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