Evaluation of perioperative applications in hepatobiliary surgery according to ERAS protocol and determination of nursing practices

In this study, it was aimed to evaluate the compliance of perioperative practices with the ERAS Protocol and to determine the nursing practices of patients who had hepatobiliary surgery. In this descriptive study, it was conducted with 180 patients who underwent hepatobiliary surgery in Bursa Uludağ University Hospital General Surgery Clinic between January 2021 and June 2021. The data in the research were collected using the socio-demographic data collection form and the ERAS protocol information form developed in line with the literature. Percentage distributions, means, Shapiro Wilk, Kolmogorov-Smirnov test, Mann Whitney U test, Kruskal Wallis test, Dunn-Bonferroni test, Pearson Chi Square test, Fisher's exact test, in the Statistical Package for Social Science for Windows (SPSS) 22 program and Fisher-Freeman-Halton test was used. In statistical analyzes, p<0.05 was taken as the level of significance. In this study, it was found that 60% of the patients underwent gallbladder and bile duct surgery, 21.1% underwent pancreatic surgery, and 18.9% underwent liver surgery. Surgical interventions applied to patients; 46.7% were laparoscopic cholecystectomy, 17.2% whipple procedure, 14.4% liver resection, 9.4% common bile duct surgery. In the study, nutritional support was started in 14.4% of the patients before the operation. Mechanical bowel preparation was not performed in any of the patients. The fasting period of all patients started from 24 at night. Thrombo-embolism prophylaxis was applied to 46.7% of the patients in the study. Antibiotic prophylaxis was administered to 62.8% of the patients in the study before the skin incision. Minimally invasive surgery was performed in 51.1% of the patients in the study. There was a nasogastric drain in 51.1% of the patients in the study, and the Foley catheters of the patients were removed in an average of 0 (0-11) days, and an average of 1 (0-5) days. An abdominal drain was present in 64.4% of the patients in the study, and the drains were removed in 3 (1-10) days on average. The patients were started on liquid food on an average of 1 (0-13) day and solid food on 1 (0-15) day after surgery. Paracetamol and NSAIDs were used as analgesics in 47.2% of the patients postoperatively. Antiemetic was administered to 92.2% of the patients postoperatively. The patients in our study were mobilized at an average of 6 (4-24) hours after surgery. Nurses play an active role in the application of ERAS components from the preoperative period to the postoperative period. Keywords: ERAS, hepatobiliary surgery,perioperative practice,nursing