Nursing measures	Control group	Study group
Preoperative propaganda and education	Carry on orally. Routine health education	In the form of publicity manuals and educational lectures, this paper introduces in detail the causes of extrahepatic bile duct stones and the related knowledge of laparoscopic bile duct exploration and stone extraction, anesthesia-related complications, surgical necessity, intraoperative and postoperative complications and countermeasures, alternative treatment, eliminate patients’ nervousness and increase patients’ cooperation.
Preoperative diet	Fasting 8 hours before operation and water fasting 4 hours before operation	Fasting 6 hours before operation and water deprivation 2 hours before operation, but glucose injection warmed by 400 ml can be given 2 - 3 hours before operation.
Preoperative intestinal preparation	Routine intestinal preparation before operation	No need for intestinal preparation and gastrointestinal decompression before operation
Pre-operative training	Routine activities	Before operation, patients were instructed to blow balloons to exercise their lung function, walk in the corridor to exercise their physical fitness, and those who had a history of smoking gave up smoking before operation.
Preoperative catheterization	Place gastric tube and urinary catheter	Irregular placement of gastric tube and urinary catheter before operation
Intraoperative nursing	Routine nursing care, placement of abdominal drainage, routine nursing and warmth of related pipes	On the basis of routine nursing, relatively raise the temperature of the operating room more than 25˚C, use thermal blanket or thermal insulation quilt to keep the patients warm, keep the peritoneal lavage fluid warm, and reduce the amount of fluid replacement during the operation.
Intraoperative nursing
Nursing care of postoperative pain relief	Routine indwelling intravenous analgesia pump and adding opioid analgesics if necessary	Postoperative epidural analgesia was given, pain scale was used to evaluate the degree of pain, and morphine analgesia was given if necessary.
Postoperative diet	After exhaust, begin to eat and remove the gastric tube, gradually transition from fluid to general food.	Six hours after operation, chewing gum and a small amount of drinking water were given. On the first day, a light liquid diet began, and on the second day, a semi-fluid diet began, and then gradually returned to a normal diet.
Early postoperative activity	The patient got out of bed voluntarily after 2 - 3 days of operation, and the catheter was removed after getting out of bed.	6 hours after anesthesia, patients are encouraged to exercise in the ground for 2 - 3 times on the first day after operation. The appropriate amount of activity is that the patients do not dare to get tired, and then the daily activity gradually increases.
Pipeline nursing	When the peritoneal fluid is clear and small, the drainage tube is removed, and the patients are informed of the matters needing attention after operation.	Removal of abdominal drainage tube within 48 - 72 hours after operation
Discharged from hospital to preach	Matters needing attention in routine out-of-hospital nursing	Do a good job in propaganda and education on diet, activities, pipes and wounds of discharged patients, use oral, demonstration, paper text and other propaganda and education methods, do a good job in regular follow-up work, and grasp the rehabilitation of patients.