Application of enhanced recovery after surgery in same-day surgery laparoscopic cholecystectomy_West China Medical Journal

Authors：

XIONG Huan ¹ , CAO Junqiu ^1,2 , WU Chengxi ¹ , CHEN Hongyu ^3,4 ,  CHEN Yonghua ^3,4

1. Day Surgery Center, West China Tianfu Hospital, Sichuan University, Chengdu, Sichuan 610213, P. R. China;
2. Day Surgery Center, General Practice Medical Center, West China Hospital, Sichuan University, Chengdu, Sichuan 610041, P. R. China;
3. Division of Pancreatic Surgery, Department of General Surgery, West China Hospital, Sichuan University, Chengdu, Sichuan 610041, P. R. China;
4. General Surgery One, West China Tianfu Hospital, Sichuan University, Chengdu, Sichuan 610213, P. R. China;

Corresponding?author：

CHEN Yonghua, Email: chenyonghua2007@163.com

Keywords：

Enhanced recovery after surgery; same-day surgery; day surgery; laparoscopic cholecystectomy; perioperative management

DOI：

10.7507/1002-0179.202601084

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Objective To investigate the safety, feasibility, and clinical value of applying the enhanced recovery after surgery (ERAS) protocol in laparoscopic cholecystectomy (LC) performed under a same-day surgery model. Methods Clinical data of patients undergoing LC at West China Tianfu Hospital, Sichuan University between November 2023 and December 2024 were retrospectively analyzed. Patients who voluntarily chose the same-day discharge model prior to admission were assigned to the same-day surgery group, while those who opted for multi-day hospitalization in the general ward were assigned to the general ward group. The baseline characteristics, perioperative outcomes, postoperative complications, length of stay, preoperative waiting time, total hospitalization costs, and postoperative follow-up of the two groups were analyzed. Results A total of 499 patients were included. Among them, 248 were in the same-day surgery group and 251 were in the general ward group. There were statistically significant differences in age, history of chronic cholecystitis, postoperative nausea and vomiting severity, preoperative/intraoperative analgesia, total anesthesia duration, surgical duration, intraoperative blood loss, Visual Analogue Scale scores after returning to the ward, and postoperative nausea and vomiting incidence between the two groups (P<0.05). The same-day surgery group had significantly shorter hospitalization and preoperative waiting times, lower total hospital costs (P<0.05). Conclusions LC performed under the same-day surgery model combined with ERAS principles is safe and feasible. It conforms to the core principles of day surgery—minimal invasiveness, high efficiency, and safety—and delivers superior patients’ experience and satisfaction compared with general ward management.

Citation： XIONG Huan, CAO Junqiu, WU Chengxi, CHEN Hongyu, CHEN Yonghua. Application of enhanced recovery after surgery in same-day surgery laparoscopic cholecystectomy. West China Medical Journal, 2026, 41(8): 1295-1299. doi: 10.7507/1002-0179.202601084 Copy

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3.	Xiong W, Li M, Wang M, et al. The safety of laparoscopic cholecystectomy in the day surgery unit comparing with that in the inpatient unit: a systematic review and meta-analysis[J]. Biomed Res Int, 2020, 2020: 1924134.
4.	張光永, 劉崇忠, 朱健康, 等. 日間腹腔鏡膽囊切除術專家共識[J]. 臨床肝膽病雜志, 2023, 39(11): 2550-2557.
5.	Tenconi SM, Boni L, Colombo EM, et al. Laparoscopic cholecystectomy as day-surgery procedure: current indications and patients’ selection[J]. Int J Surg, 2008, 6(Suppl 1): S86-S88.
6.	于麗華. 中國日間手術發展的歷程與展望[J]. 中國醫院管理, 2016, 36(6): 16-18.
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11.	Cassinotti E, Colombo EM, Di Giuseppe M, et al. Current indications for laparoscopy in day-case surgery[J]. Int J Surg, 2008, 6(Suppl 1): S93-S96.
12.	夏加英, 羊馥華, 羊紅兒, 等. 加速康復外科理念聯合日間手術模式在腹腔鏡膽囊切除術中的應用價值分析[J]. 中華危重癥醫學雜志 (電子版), 2021, 14(4): 312-315.
13.	劉力瑋, 鄭亞民, 劉東斌, 等. 日間腹腔鏡膽囊切除術的可行性分析[J]. 腹腔鏡外科雜志, 2021, 26(5): 359-362.
14.	魯發順, 鐘鍇, 穆熱艾合買提江·穆塔里夫, 等. 日間模式應用于腹腔鏡膽囊切除術的療效分析[J]. 中國普外基礎與臨床雜志, 2021, 28(7): 856-860.
15.	李龍, 焦作義, 羅長江. 日間手術腹腔鏡膽囊切除術療效和安全性的 Meta 分析[J]. 中華普通外科學文獻 (電子版), 2018, 12(6): 444-450.
16.	雷甜甜, 黃明君, 梁鵬, 等. 日間手術精準排程的研究現狀及進展[J]. 華西醫學, 2024, 39(2): 308-312.
17.	Asklid D, Segelman J, Gedda C, et al. The impact of perioperative fluid therapy on short-term outcomes and 5-year survival among patients undergoing colorectal cancer surgery - a prospective cohort study within an ERAS protocol[J]. Eur J Surg Oncol, 2017, 43(8): 1433-1439.
18.	梁豪, 熊志勇, 姚志成, 等. 快速康復外科在腹腔鏡膽囊切除術圍手術期應用的 meta 分析[J]. 中華肝臟外科手術學電子雜志, 2017, 6(4): 307-311.
19.	趙睿. 日間手術結合加速康復外科理念在腹腔鏡膽囊切除術中的應用效果[J]. 中國當代醫藥, 2021, 28(31): 56-59.
20.	張敏, 張富杰, 譚會領, 等. 加速康復外科在腹腔鏡膽囊切除術患者中的應用[J]. 河北醫科大學學報, 2023, 44(5): 589-595.
21.	羊衛剛. 加速康復外科對腹腔鏡膽囊切除術患者術后全身炎癥應激狀態及康復質量影響的觀察[J]. 中國中西醫結合外科雜志, 2020, 26(1): 98-102.
22.	沈艷玲, 通耀威, 張曉倩. 日間與住院腹腔鏡膽囊切除術療效的 Meta 分析[J]. 腹腔鏡外科雜志, 2022, 27(6): 439-446.
23.	曹俊秋, 熊桓, 宋應寒, 等. 日歸模式腹腔鏡膽囊切除術的可行性及安全性[J]. 中國普外基礎與臨床雜志, 2025, 32(11): 1437-1442.
24.	劉洋, 張一敏, 王小成, 等. 四川大學華西醫院日間手術出院后管理規范[J]. 華西醫學, 2019, 34(2): 137-139.

1. 孟檸, 徐鑫, 沈波, 等. 日間手術模式在腹腔鏡膽囊切除術中的應用[J]. 全科醫學臨床與教育, 2014, 12(3): 291-293.
2. Kim SS, Donahue TR. Laparoscopic cholecystectomy[J]. JAMA, 2018, 319(17): 1834.
3. Xiong W, Li M, Wang M, et al. The safety of laparoscopic cholecystectomy in the day surgery unit comparing with that in the inpatient unit: a systematic review and meta-analysis[J]. Biomed Res Int, 2020, 2020: 1924134.
4. 張光永, 劉崇忠, 朱健康, 等. 日間腹腔鏡膽囊切除術專家共識[J]. 臨床肝膽病雜志, 2023, 39(11): 2550-2557.
5. Tenconi SM, Boni L, Colombo EM, et al. Laparoscopic cholecystectomy as day-surgery procedure: current indications and patients’ selection[J]. Int J Surg, 2008, 6(Suppl 1): S86-S88.
6. 于麗華. 中國日間手術發展的歷程與展望[J]. 中國醫院管理, 2016, 36(6): 16-18.
7. 吳佳男. 從“日間”到“日歸”: 精益手術更進一步[J]. 中國醫院院長, 2021, 17(18): 48-49.
8. 雷甜甜, 梁鵬, 馬洪升, 等. 四川大學華西醫院日歸手術管理實踐[J]. 廣東醫學, 2022, 43(10): 1222-1228.
9. 陳凜, 陳亞進, 董海龍, 等. 加速康復外科中國專家共識及路徑管理指南 (2018 版)[J]. 中國實用外科雜志, 2018, 38(1): 1-20.
10. Curtis NJ, Robinson PD, Carty NJ. Single hospital visit elective day-case laparoscopic cholecystectomy without prior outpatient attendance[J]. Surg Endosc, 2017, 31(9): 3574-3580.
11. Cassinotti E, Colombo EM, Di Giuseppe M, et al. Current indications for laparoscopy in day-case surgery[J]. Int J Surg, 2008, 6(Suppl 1): S93-S96.
12. 夏加英, 羊馥華, 羊紅兒, 等. 加速康復外科理念聯合日間手術模式在腹腔鏡膽囊切除術中的應用價值分析[J]. 中華危重癥醫學雜志 (電子版), 2021, 14(4): 312-315.
13. 劉力瑋, 鄭亞民, 劉東斌, 等. 日間腹腔鏡膽囊切除術的可行性分析[J]. 腹腔鏡外科雜志, 2021, 26(5): 359-362.
14. 魯發順, 鐘鍇, 穆熱艾合買提江·穆塔里夫, 等. 日間模式應用于腹腔鏡膽囊切除術的療效分析[J]. 中國普外基礎與臨床雜志, 2021, 28(7): 856-860.
15. 李龍, 焦作義, 羅長江. 日間手術腹腔鏡膽囊切除術療效和安全性的 Meta 分析[J]. 中華普通外科學文獻 (電子版), 2018, 12(6): 444-450.
16. 雷甜甜, 黃明君, 梁鵬, 等. 日間手術精準排程的研究現狀及進展[J]. 華西醫學, 2024, 39(2): 308-312.
17. Asklid D, Segelman J, Gedda C, et al. The impact of perioperative fluid therapy on short-term outcomes and 5-year survival among patients undergoing colorectal cancer surgery - a prospective cohort study within an ERAS protocol[J]. Eur J Surg Oncol, 2017, 43(8): 1433-1439.
18. 梁豪, 熊志勇, 姚志成, 等. 快速康復外科在腹腔鏡膽囊切除術圍手術期應用的 meta 分析[J]. 中華肝臟外科手術學電子雜志, 2017, 6(4): 307-311.
19. 趙睿. 日間手術結合加速康復外科理念在腹腔鏡膽囊切除術中的應用效果[J]. 中國當代醫藥, 2021, 28(31): 56-59.
20. 張敏, 張富杰, 譚會領, 等. 加速康復外科在腹腔鏡膽囊切除術患者中的應用[J]. 河北醫科大學學報, 2023, 44(5): 589-595.
21. 羊衛剛. 加速康復外科對腹腔鏡膽囊切除術患者術后全身炎癥應激狀態及康復質量影響的觀察[J]. 中國中西醫結合外科雜志, 2020, 26(1): 98-102.
22. 沈艷玲, 通耀威, 張曉倩. 日間與住院腹腔鏡膽囊切除術療效的 Meta 分析[J]. 腹腔鏡外科雜志, 2022, 27(6): 439-446.
23. 曹俊秋, 熊桓, 宋應寒, 等. 日歸模式腹腔鏡膽囊切除術的可行性及安全性[J]. 中國普外基礎與臨床雜志, 2025, 32(11): 1437-1442.
24. 劉洋, 張一敏, 王小成, 等. 四川大學華西醫院日間手術出院后管理規范[J]. 華西醫學, 2019, 34(2): 137-139.

West China Medical Journal

Application of enhanced recovery after surgery in same-day surgery laparoscopic cholecystectomy

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