Resumption of daily physical activity after day-case laparoscopic cholecystectomy

Background  Laparoscopic cholecystectomy has been proven to be safe and feasible as a day-case procedure. Few studies investigated postoperative activity resumption. The goal of this study was to objectively assess daily physical activity after day-case laparoscopic cholecystectomy and evaluate the effect of encouragement of patients. Methods  This prospective controlled study measured daily physical activity in an unselected patient population undergoing day-case laparoscopic cholecystectomy by using an accelerometer for 1 week before surgery to 1 week after. First, a control group received standard care. Subsequently, an intervention group was encouraged to swift resumption of daily physical activity by means of standardized advice combined with individualized activity goals. Outcome measures were activity scores, visual analogue scores (VAS) for pain and nausea and subjective factors limiting activity. Results  Sixty-four patients completed the study (n = 28 in the control group, n = 36 in the intervention group). In the control group, 36% of the patients reached their preoperative activity level after 1 week, as compared to 50% in the intervention group (p = 0.19). Resumption of daily physical activity during the first postoperative week in the intervention group was not significantly different from the control group [repeated measures analysis of variance (MANOVA), p = 0.05]. However, in contrast with men, women in the intervention group did show a faster recovery of daily physical activity as compared to the control group (MANOVA, p = 0.02). Although there was no significant difference in postoperative VAS scores for pain and nausea between both groups, patients in the intervention group experienced pain less often as a limiting factor (p = 0.006). Conclusion  Recovery of daily physical activity exceeded 1 week in most patients undergoing day-case laparoscopic cholecystectomy. The use of an accelerometer and standardized encouragement accelerated recovery in women.