Comparison of Postoperative Outcomes with and Without Enhanced Recovery after Surgery (ERAS) Protocols in Patients Undergoing Laparoscopic Cholecystectomy

ERAS Protocols in Laparoscopic Cholecystectomy

Abstract

Background: The application of ERAS protocols has revolutionized perioperative care but their role in laparoscopic cholecystectomy (LC) remains underexplored in many settings. Objective: Comparing the postoperative results of patients having laparoscopic cholecystectomy with and without the use of ERAS protocols. Study Design: Randomized controlled trial. Settings: Department of Surgery, Allied Hospital, Faisalabad Pakistan. Duration: 01-12-2024 to 31-07-2025 (eight months). Results: 160 patients, 51 Male and 109 female patients participated. In Group A, only one patient was placed on a drain, while in Group B, 49 patients had a drain. Pain score mean in Group A was 2.4 after 04hrs,2.3 after 08 hrs,1.6 after 12 hrs,1.1 after 24 hrs. Pain score mean in Group B was 3.7 after four hrs., 3.1 after 08 hrs., 2.8 after 12 hrs., 2.2 after 24 hrs. Activity score mean in Group A was 1.6 after four hrs.,2.3 after 08 hrs,2.8 after 12 hrs,3.8 after 24 hrs. Activity score mean in Group B was 0.86 after four hrs., 0.86 after 08 hrs., 1.6 after 12 hrs., 2.3 after 24 hrs. Rescue analgesia mean is 0.17 (0.44) and 2.3 (SD = 0.62)in groups A and B, respectively. Mean postoperative hospital stay was 1.1 and 1.7 in groups A and B, respectively. Mean postoperative ileus was 2 and 1.9 in groups A and B, respectively. Conclusion: The application of ERAS protocols resulted in less postoperative pain, earlier mobility, and the ability to perform routine activities, a reduced need for rescue analgesia, and an earlier oral-free status, as well as earlier discharge from the hospital.