Results of implementation of a multimodal fast track recovery program in treatment of patients with cholelithiasis
Aim - to improve immediate outcomes of surgical treatment in patients with cholelithiasis by implementing a multimodal fast track recovery program. The study involved 156 patients with cholelithiasis. Women (114, 61,3%) overnumbered men. The patients of the main group underwent intrathecal anesthesia with right sided superficial cervical plexus blockade, permeation anesthesia of diaphragm and previous anesthesia of trocar wounds. In the control group, anesthesia was performed by the standard method of endotracheal anesthesia. During laparoscopic cholecystectomy the cystic duct remnant forming was carried out by using electric welding of biological tissues in all the cases of both main and control groups. According to statistic data the subjective assessment of life quality and satisfaction with treatment outcomes turned out to be significantly better in the main group of patients. The level of pain by the Visual Analogue Scale (VAS) was measured as 2,5 ± 0,3 (p<0,05) points (on the 10 - point scale) in the main group, satisfaction with treatment outcomes was 4,6 + 0,2 (p>0,05) points (on the 5-point scale). The average bed day was 1,5 ± 0,5 days. In the control group, the level of pain the patients assessed as 5,5 ± 0,3 points by the VAS, satisfaction with treatment outcomes was 3.6 + 0.2 points. The average patient day in hospital was 3,0 ± 0,5 days. Laparoscopic cholecystectomy combined with a multimodal fast track recovery program is a safe treatment strategy which can be considered as alternative one to standard treatment and rehabilitation strategies for the patients with cholelithiasis.