关键词: 加速康复外科, 胆总管切开取石术, 机器人, 腹腔镜

Abstract:

Objective To explore the clinical experience of laparoscopic and robot assisted choledocholithotomy under enhanced recovery after surgery(ERAS) mode. Method The clinical data of 193 patients with choledocholithotomy in the Eastern Hospital of Qingdao Municipal Hospital from January 2020 to April 2025 were retrospectively analyzed. The operation methods, intraoperative bleeding and postoperative complications were summarized. The perioperative period and prognosis of laparoscopic and robot assisted choledocholithotomy were compared. Result of the 193 patients, 177 underwent laparoscopic surgery and 16 underwent robot assisted surgery. The operation time was (144.84±54.17)min, the intraoperative blood loss was (18.96±22.11)ml, and the postoperative hospital stay was (5.85±3.60)d. There were 85 cases of primary suture of common bile duct and 108 cases of indwelling T-tube (56%). There were 2 cases of postoperative pneumonia, 2 cases of urinary tract infection, 1 case of abdominal infection, 1 case of peritoneal effusion, 1 case of incision infection, 1 case of lower extremity venous thrombosis, all of which were improved by conservative treatment, 1 case of relatively narrow common bile duct occurred after operation, and improved after balloon dilatation of common bile duct. The total cost of hospitalization in the robot surgery group was higher than that in the laparoscopic surgery group [(52 167.09±10 079.63)yuan vs (23 882.27±10 289.22)yuan], and the difference was significant (P ＜ 0.001). Conclusion Minimally invasive choledocholithotomy under accelerated rehabilitation mode can reduce the perioperative stress response of patients and promote the rehabilitation of patients.

Key words: Enhanced recovery after surgery, Choledocholithotomy, Robot, Laparoscope