Zhou LL, Li CL, Zhang JF, Wu C, Cheng ZJ. Fu Zheng Li Qi Tang combined with FOCUS-PDCA model in postoperative rehabilitation of elderly biliary surgery patients. World J Gastrointest Surg 2026; 18(1): 113989 [DOI: 10.4240/wjgs.v18.i1.113989]
Corresponding Author of This Article
Chun Wu, PhD, Department of Rehabilitation, Shibei Hospital of Jing’an District, No. 4500 Gonghexin Road, Jing’an District, Shanghai 200443, China. wuchun24007@163.com
Research Domain of This Article
Rehabilitation
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Retrospective Study
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This article is an open-access article which was selected by an in-house editor and fully peer-reviewed by external reviewers. It is distributed in accordance with the Creative Commons Attribution Non Commercial (CC BY-NC 4.0) license, which permits others to distribute, remix, adapt, build upon this work non-commercially, and license their derivative works on different terms, provided the original work is properly cited and the use is non-commercial. See: http://creativecommons.org/licenses/by-nc/4.0/
Jan 27, 2026 (publication date) through Jan 28, 2026
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World Journal of Gastrointestinal Surgery
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1948-9366
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Baishideng Publishing Group Inc, 7041 Koll Center Parkway, Suite 160, Pleasanton, CA 94566, USA
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Zhou LL, Li CL, Zhang JF, Wu C, Cheng ZJ. Fu Zheng Li Qi Tang combined with FOCUS-PDCA model in postoperative rehabilitation of elderly biliary surgery patients. World J Gastrointest Surg 2026; 18(1): 113989 [DOI: 10.4240/wjgs.v18.i1.113989]
World J Gastrointest Surg. Jan 27, 2026; 18(1): 113989 Published online Jan 27, 2026. doi: 10.4240/wjgs.v18.i1.113989
Fu Zheng Li Qi Tang combined with FOCUS-PDCA model in postoperative rehabilitation of elderly biliary surgery patients
Liu-Liu Zhou, Chun-Ling Li, Jin-Feng Zhang, Chun Wu, Zhi-Jun Cheng
Liu-Liu Zhou, Department of Gastroenterology, Chongming Branch of Shanghai Tenth People’s Hospital, Tongji University School of Medicine, Shanghai 202157, China
Chun-Ling Li, Department of General Medicine, Xinqiao Town Community Health Service Center, Shanghai 201612, China
Jin-Feng Zhang, Department of General Medicine, Pudong Hospital, Shanghai 200032, China
Chun Wu, Department of Rehabilitation, Shibei Hospital of Jing’an District, Shanghai 200443, China
Zhi-Jun Cheng, Department of Anesthesiology, Chongming Hospital Affiliated to Shanghai University of Medicine & Health Sciences, Shanghai 202150, China
Co-corresponding authors: Chun Wu and Zhi-Jun Cheng.
Author contributions: Zhou LL, Li CL, Zhang JF, Wu C, and Cheng ZJ contributed to research design and data analysis; Zhou LL, Li CL, Zhang JF, and Cheng ZJ contributed to data collection, and paper writing; Wu C was responsible for funding application, reviewing and editing, communication coordination, ethical review, copyright and licensing, and follow-up. Wu C and Cheng ZJ contributed equally to this manuscript and are co-corresponding authors. All author approval the final manuscript.
Institutional review board statement: This retrospective study was approved by the Ethics Committee of the Chongming Branch of Shanghai Tenth People’s Hospital (Approval No. SHSYCM-IEC-1.0/25-YF/05).
Informed consent statement: All research participants or their legal guardians provided written informed consent prior to study registration.
Conflict-of-interest statement: All the authors report no relevant conflicts of interest for this article.
Data sharing statement: No other data available.
Open Access: This article is an open-access article that was selected by an in-house editor and fully peer-reviewed by external reviewers. It is distributed in accordance with the Creative Commons Attribution NonCommercial (CC BY-NC 4.0) license, which permits others to distribute, remix, adapt, build upon this work non-commercially, and license their derivative works on different terms, provided the original work is properly cited and the use is non-commercial. See: https://creativecommons.org/Licenses/by-nc/4.0/
Corresponding author: Chun Wu, PhD, Department of Rehabilitation, Shibei Hospital of Jing’an District, No. 4500 Gonghexin Road, Jing’an District, Shanghai 200443, China. wuchun24007@163.com
Received: September 12, 2025 Revised: October 13, 2025 Accepted: November 10, 2025 Published online: January 27, 2026 Processing time: 131 Days and 2.3 Hours
Abstract
BACKGROUND
Elderly patients undergoing biliary surgery face high risks of postoperative complications and delayed recovery due to reduced physiological reserve and frequent comorbidities. Effective rehabilitation strategies are urgently needed. Traditional Chinese medicine, such as Fu Zheng Li Qi Tang, may support recovery through multi-targeted regulation, while the find, organize, clarify, understand, select, plan, do, check and act (FOCUS-PDCA) model offers a systematic approach to optimize nursing quality. We hypothesized that combining Fu Zheng Li Qi Tang with the FOCUS-PDCA model would significantly improve postoperative recovery in elderly biliary surgery patients compared to routine care.
AIM
To evaluate the effect of Fu Zheng Li Qi Tang plus FOCUS-PDCA on postoperative recovery in elderly biliary surgery patients.
METHODS
One hundred and twenty elderly biliary surgery patients (age ≥ 60 years) were randomized into a control group (n = 60) receiving Fu Zheng Li Qi Tang and routine nursing, and an observation group (n = 60) receiving additional FOCUS-PDCA model. Postoperative recovery indicators (time to first flatus, ambulation, hospitalization), Visual Analog Scale pain scores, complications, and nursing satisfaction were compared.
RESULTS
The duration of postoperative bed rest, time to first flatus, and length of hospital stay in the observational group were all shorter than those in the control group (P < 0.0001). The Visual Analog Scale scores of patients in both groups at all time points after the operation were significantly reduced, and the scores of the observation group at all time points were lower than that of the control group (P < 0.0001). Moreover, the total incidence rate of complications in the patients of the observation group was lower, and the satisfaction with the nursing care was higher (P < 0.05).
CONCLUSION
Fu Zheng Li Qi Tang combined with FOCUS-PDCA model accelerates postoperative recovery, relieves pain, reduces complications, and improves nursing satisfaction in elderly biliary surgery patients, demonstrating significant clinical value.
Core Tip: This study determined the application value of the Fu Zheng Li Qi Tang combined with the find, organize, clarify, understand, select, plan, do, check and act (FOCUS-PDCA) model in postoperative recovery for elderly patients undergoing biliary surgery. The integration of traditional Chinese physiological regulation and optimized nursing care in this combination outperformed the use of Fu Zheng Li Qi Tang alone in accelerating recovery, reducing bed rest, time to flatus passage, hospital stay duration, and complications, while also improving satisfaction. This research fills part of the gap in postoperative recovery management for elderly individuals undergoing biliary surgery and has significant clinical application value.
