Application of enhanced recovery after surgery in laparoscopic biliary reoperation for extrahepatic bile duct stones.

OBJECTIVE

To evaluate the safety and efficacy of enhanced recovery after surgery (ERAS) protocols in laparoscopic biliary reoperations for extrahepatic bile duct stones.

METHODS

A total of 60 patients with prior biliary surgery were randomly assigned to either an ERAS group or a control group (n = 30 each). Both groups underwent laparoscopic bile duct exploration. Perioperative outcomes, inflammatory markers (CRP, IL-6), and nutritional indicators (prealbumin) were compared. Functional recovery, quality of life (SF-36), and complications were also assessed.

RESULTS

The ERAS group showed significantly shorter time to first flatus, faster ambulation and oral intake, lower pain scores, shorter hospital stays, and reduced hospitalization costs (P < 0.05). Patient satisfaction at discharge and 3 months postoperatively was significantly higher. SF-36 scores at 4 weeks showed better physical function, vitality, and general health in the ERAS group. CRP and IL-6 levels were lower, and prealbumin levels were higher postoperatively in the ERAS group (P < 0.05). The incidence of complications such as severe nausea and vomiting was lower in the ERAS group.

CONCLUSIONS

ERAS is a safe and effective strategy in laparoscopic reoperation for extrahepatic bile duct stones. It significantly improves early recovery, reduces inflammation and costs, enhances patient satisfaction, and supports wider adoption of ERAS in hepatobiliary surgery.