Perioperative management based on the enhanced recovery after surgery concept in elderly patients undergoing laparoscopic common bile duct exploration plus laparoscopic cholecystectomy

doi:10.4240/wjgs.120366

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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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Copyright: ©Author(s) 2026. This article is an open access article distributed under the terms and conditions of the Creative Commons Attribution-NonCommercial (CC BY-NC 4.0) license. No commercial re-use. See permissions. Published by Baishideng Publishing Group Inc.

World J Gastrointest Surg. Aug 27, 2026; 18(8): 120366
Published online Aug 27, 2026. doi: 10.4240/wjgs.120366

Table 1 Comparison of general characteristics between the two groups, n (%)/mean ± SD

Indicator	Gender		Age (years)	Number of CBD stones	CBD diameter (mm)	Chronic comorbidities	Previous abdominal surgery
Indicator	Male	Female	Age (years)	Number of CBD stones	CBD diameter (mm)	Chronic comorbidities	Previous abdominal surgery
Control group (n = 40)	19 (47.50)	21 (52.50)	67.47 ± 6.28	2.41 ± 0.28	8.89 ± 1.78	18 (45.00)	4 (10.00)
ERAS group (n = 40)	21 (52.50)	19 (47.50)	66.47 ± 4.89	2.39 ± 0.37	9.15 ± 4.13	21 (52.50)	2 (5.00)
t/χ²	0.200		0.000¹	0.271¹	0.365¹	0.450²	0.721²
P value	0.823		1.000	0.787	0.716	0.655	0.675

¹t-test.

²χ² test.

CBD: Common bile duct; ERAS: Enhanced recovery after surgery.

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Table 2 Comparison of gastrointestinal function recovery indicators between groups, mean ± SD

Group	Time to first flatus (hours)	Time to bowel sound recovery (hours)	Time to first defecation (days)	Total IV fluid volume (L)
Control group (n = 40)	48.52 ± 6.64	34.89 ± 4.36	3.83 ± 0.64	8.87 ± 0.85
ERAS group (n = 40)	38.56 ± 4.65	21.95 ± 3.22	2.75 ± 0.63	6.54 ± 0.57
t	7.772	15.107	7.592	14.402
P value	0.000	0.000	0.000	0.000

ERAS: Enhanced recovery after surgery.

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Table 3 Comparison of inflammatory factor levels between groups, mean ± SD

Group	hs-CRP (mg/L)		IL-6 (pg/mL)		TNF-α (pg/mL)
Group	Preop	Postop 3 days	Preop	Postop 3 days	Preop	Postop 3 days
Control group (n = 40)	132.90 ± 14.35	79.29 ± 9.56^a	93.29 ± 8.55	47.68 ± 4.66^a	2.45 ± 0.47	0.96 ± 0.14^a
ERAS group (n = 40)	128.89 ± 13.94	73.37 ± 8.73^a	94.29 ± 9.57	41.29 ± 4.74^a	2.56 ± 0.78	0.75 ± 0.12^a
t	1.268	2.897	0.493	6.074	0.824	7.341
P value	0.209	0.005	0.623	0.000	0.412	0.000

^aP < 0.05 compared with preoperative level in the same group.

hs-CRP: High-sensitivity C-reactive protein; IL-6: Interleukin-6; TNF-α: Tumor necrosis factor-α; ERAS: Enhanced recovery after surgery.

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Table 4 Comparison of pain status between groups, mean ± SD

Group	Preop VAS score (score)	Postop 3 days VAS score (score)	Postop pain duration (hours)
Control group (n = 40)	6.13 ± 1.11	4.23 ± 0.86^a	20.13 ± 2.87
ERAS group (n = 40)	5.98 ± 1.14	2.13 ± 0.46^a	14.73 ± 2.17
t	0.594	13.572	9.494
P value	0.554	0.000	0.000

^aP < 0.05 compared with preoperative level in the same group.

VAS: Visual Analog Scale; ERAS: Enhanced recovery after surgery.

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Table 5 Comparison of complication rates between groups, n (%)

Group	Nausea/vomiting	Electrolyte imbalance	Bile leak	Deep venous thrombosis	Urinary retention	Abdominal distension	Total
Control group (n = 40)	3 (7.50)	1 (2.50)	2 (5.00)	1 (2.50)	1 (2.50)	3 (7.50)	11 (27.50)
ERAS group (n = 40)	1 (2.50)	1 (2.50)	0 (0.00)	0 (0.00)	0 (0.00)	0 (0.00)	2 (5.00)
χ²							7.440
P value							0.013

ERAS: Enhanced recovery after surgery.

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Table 6 Comparison of hospital stay, hospitalization costs, and readmission rate between groups, n (%)/mean ± SD

Group	30-day readmission rate	Hospital stay (days)	Hospitalization costs (ten thousand CNY)
Control group (n = 40)	8 (20.00)	11.25 ± 0.84	3.27 ± 0.45
ERAS group (n = 40)	1 (2.50)	9.25 ± 0.71	2.51 ± 0.77
t/χ²	6.135²	11.522¹	5.349¹
P value	0.029	0.000	0.000

¹t-test.

²χ² test.

ERAS: Enhanced recovery after surgery.

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Table 7 Comparison of quality of life between groups (mean ± SD, score)

Group	Control group (n = 40)	ERAS group (n = 40)	t	P value
Mental health
Preop	62.23 ± 6.45	62.33 ± 6.56	0.069	0.945
Postop 3 days	72.63 ± 8.05^a	82.95 ± 8.34^a	5.632	0.000
Role-emotional
Preop	61.45 ± 6.56	61.55 ± 6.85	0.067	0.947
Postop 3 days	72.22 ± 7.97^a	82.23 ± 7.34^a	5.839	0.000
Social functioning
Preop	63.53 ± 6.35	63.75 ± 6.34	0.159	0.874
Postop 3 days	72.22 ± 7.45^a	82.23 ± 8.75^a	5.503	0.000
Vitality
Preop	65.23 ± 6.63	64.88 ± 6.57	0.237	0.813
Postop 3 days	73.23 ± 7.25^a	84.23 ± 7.49^a	6.675	0.000
General health
Preop	62.65 ± 5.45	62.23 ± 6.76	0.310	0.758
Postop 3 days	72.45 ± 7.05^a	82.23 ± 8.46^a	5.616	0.000
Bodily pain
Preop	61.88 ± 6.06	62.65 ± 6.15	0.568	0.572
Postop 3 days	71.25 ± 7.93^a	80.23 ± 8.55^a	4.868	0.000
Physical functioning
Preop	60.55 ± 6.28	60.23 ± 6.95	0.219	0.827
Postop 3 days	72.83 ± 7.44^a	82.23 ± 8.25^a	5.351	0.000
Role-physical
Preop	61.23 ± 6.53	62.38 ± 6.05	0.817	0.417
Postop 3 days	71.23 ± 7.35^a	82.63 ± 8.45^a	6.440	0.000

^aP < 0.05 compared with preoperative level in the same group.

ERAS: Enhanced recovery after surgery.

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Table 8 Comparison of satisfaction between groups, n (%)

Group	Very satisfied	Satisfied	Generally satisfied	Dissatisfied	Total satisfaction
Control group (n = 40)	18 (45.00)	6 (15.00)	4 (10.00)	12 (30.00)	28 (70.00)
ERAS group (n = 40)	25 (62.50)	7 (17.50)	6 (15.00)	2 (5.00)	38 (95.00)
χ²					8.658
P value					0.006

ERAS: Enhanced recovery after surgery.

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Citation: Wang LX, Jiang YH, Ding Y, Wu HT. Perioperative management based on the enhanced recovery after surgery concept in elderly patients undergoing laparoscopic common bile duct exploration plus laparoscopic cholecystectomy. World J Gastrointest Surg 2026; 18(8): 120366
URL: https://www.wjgnet.com/1948-9366/full/v18/i8/120366.htm
DOI: https://dx.doi.org/10.4240/wjgs.120366

Wang LX, Jiang YH, Ding Y, Wu HT. Perioperative management based on the enhanced recovery after surgery concept in elderly patients undergoing laparoscopic common bile duct exploration plus laparoscopic cholecystectomy. World J Gastrointest Surg 2026; 18(8): 120366 [DOI: 10.4240/wjgs.120366]

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