Comparison of Enhanced Recovery After Surgery (ERAS) protocol versus Conventional Approach for Laparoscopic Cholecystectomy: An Interventional Study

Abstract

Introduction: Laparoscopic cholecystectomy is considered the gold standard for benign gallbladder disease due to its minimal invasiveness, reduced bleeding, and rapid recovery. Enhanced Recovery After Surgery (ERAS) protocols, recognised for lowering surgical stress and complications, are increasingly adopted for their postoperative benefits. Aim: To assess and compare postoperative outcomes in laparoscopic cholecystectomy patients undergoing ERAS versus conventional approaches. Materials and Methods: This prospective interventional study was conducted at the Surgery Department of Mahatama Gandhi Medical College and Research Institute, Puducherry, India from January 2021 to June 2022. All patients above 18 years of age undergoing laparoscopic cholecystectomy with American Soceity of Anaesthesiologists (ASA) I and II were included. A total of 90 subjects, 45 subjects in the Group A (ERAS protocol) and 45 subjects in the Group B (Conventional approach), were included based on computer-generated random numbers with concealment of allocation. Key parameters, including length of hospital stay, morbidity, postoperative pain, and protocol compliance, were evaluated between both groups. Continuous variables were presented as means with standard deviations and analysed using unpaired t-tests. Categorical variables were expressed as percentages and compared using chi-square tests. Results: The mean age of the study population in ERAS and conventional was 41.3±7.9 years and 41.6±9.6 years, respectively. Similarly, 17 male participants were from the ERAS group and 15 were from the conventional group, whereas among female participants 28 were from the ERAS group and 30 were from the conventional group. The ERAS group demonstrated significant advantages: shorter hospital stays (91.2% vs. 73.4%, p=0.0274), lower Grade 1 morbidity (p=0.0213), and reduced postoperative pain (p=0.0001). Conclusion: The ERAS group exhibited notable benefits, including a shorter hospital stay, reduced morbidity, and lower postoperative pain. These findings suggest the potential for enhanced recovery outcomes with ERAS protocol implementation in laparoscopic cholecystectomy patients.

Keywords

• length of hospital stay
• morbidity
• postoperative pain