Evaluation of effectiveness of applying the concept of enhanced recovery after surgery in perioperative period of pediatric congenital choledochal cysts

WANG Wenmei; DENG Hongqiang; XIONG Quanqing; YANG Bowen; XIE Danlu; LI Liqin; WU Ling; PAN Yun; LIU Xing; ZHAO Qi

doi:10.3969/j.issn.1674-3806.2025.06.08

Abstract：Objective To evaluate the effectiveness of applying the concept of enhanced recovery after surgery(ERAS)in perioperative period of pediatric congenital choledochal cysts.Methods A retrospective analysis was conducted on the clinical data of 103 pediatric patients with congenital choledochal cysts who were admitted to Department of Pediatric Surgery,the People's Hospital of Guangxi Zhuang Autonomous Region from March 2015 to December 2023.According to whether the concept of ERAS was applied to these patients,they were divided into control group(58 patients)and observation group(45 patients).Both groups underwent laparoscopic radical surgery for choledochal cysts.The control group was managed according to traditional surgical concept and the observation group was managed according to ERAS concept in the perioperative period.The clinical and laboratory indicators during and after the operation were compared between the two groups.Results There were no statistically significant differences in gender,age,weight,preoperative white blood cell count(WBC),C-reactive protein(CRP),hemoglobin(Hb),albumin(ALB)and prealbumin(PAB)between the two groups(P＞0.05).The levels of WBC and CRP at 24 hours after operation and the level of CRP at 3 days after operation in the observation group were significantly lower than those in the control group(P＜0.05).There were no statistically significant differences in the level of Hb at 24 hours after operation and in the levels of WBC and Hb at 3 days after operation between the two groups(P＞0.05).There were no statistically significant differences in the levels of WBC,CRP,Hb,ALB and PAB at 2 weeks after operation between the two groups(P＞0.05).The pediatric patients in both groups were cured and discharged from the hospital.None of these patients were readmitted to hospital within 30 days after the operation.There were no significant differences in the duration of operation and intraoperative blood loss between the two groups(P＞0.05).Compared with the pediatric patients in the control group,the pediatric patients in the observation group had earlier recovery time of bowel sounds and shorter hospital stay after operation,and less hospitalization expenses,with statistically significant differences(P＜0.05).There was no statistically significant difference in the incidence of postoperative complications between the two groups(P＞0.05).The satisfaction rate of the observation group was significantly higher than that of the control group(P＜0.05).Conclusion The application of the ERAS concept is safe,effective and feasible in the perioperative period of pediatric congenital choledochal cysts.It has clinical application value and is worthy of further research and promotion in clinical practice.