To explore the effects of preoperative oral carbohydrate on patients with post-ERCP insulin resistance and psychological recovery.

The subjects of this prospective study were 120 patients who underwent endoscopic retrograde cholangiopancreatography (ERCP) at Xinhua Hospital Affiliated to Shanghai Jiao Tong University School of Medicine from January 2017 to December 2018. The informed consents of all patients were obtained and the local ethical committee approval was received. Among them, 67 patients were male and 53 female, with a mean age of (67±17) years. Patients were randomly assigned to the observation group and the control group according to the random number table method with 60 cases in each group. 1 000 ml and 500 ml of 10% glucose solution were given orally to the patients in observation group on the night before surgery and 2 h before surgery respectively. Patients in control group were on fasting for 8 h and deprived of water for 6 h preoperatively. Intraoperative aspiration, as well as perioperative blood insulin concentration, homeostasis model assessment-insulin resistance (HOMA-IR), self-rating anxiety scale (SAS), and length of hospital stay in patients of both groups were observed. Perioperative status of two groups was compared using t test.

ERCP were successfully performed in both groups without aspiration. The insulin concentration and HOMA-IR at postoperative 3 h in observation group were (8.6±2.7) mmol/L and (2.8±1.2) mU/L, which were significantly lower than (14.2±3.7) mmol/L, (4.8±1.5) mU/L in control group (t=-2.91, -2.62; P<0.05). The insulin concentration and HOMA-IR on postoperative 1 d in observation group were (9.1±2.6) mmol/L and (2.9±1.1) mU/L, significantly lower than (15.1±4.1) mmol/L, (5.1±1.7) mU/L in control group (t=-2.74, -2.95; P<0.05). The postoperative SAS in observation group was 32±6, significantly lower than 38±8 in control group (t=-2.98, P<0.05). The score for nursing satisfaction, treatment compliance, and quality of life in observation group was 94±5, 92±5, and 91±5, respectively, which were significantly higher than 83±5, 80±4, and 79±5 in control group (t=2.46, 2.85, 2.74; P<0.05). The length of hospital stay in observation group was (5.6±2.2) d, significantly shorter than (7.6±4.1) d in control group (t=-3.31, P<0.05).

Pre-ERCP oral carbohydrate does not increase the risk of surgical complications such as aspiration, while reducing insulin resistance, relieving postoperative anxiety, shortening hospital stay, and accelerating patient recovery.