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

## TL;DR

This study shows that using ERAS protocols in laparoscopic biliary reoperations for bile duct stones improves recovery, reduces inflammation, and lowers hospital costs.

## Contribution

Demonstrates the safety and efficacy of ERAS in laparoscopic biliary reoperations for extrahepatic bile duct stones.

## Key findings

- ERAS group had faster recovery, lower pain, shorter hospital stays, and reduced costs.
- ERAS improved patient satisfaction and quality of life scores compared to controls.
- ERAS reduced inflammatory markers and increased nutritional indicators postoperatively.

## Abstract

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

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.

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.

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.