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Factors determining convalescence after uncomplicated laparoscopic cholecystectomy
T Bisgaard1, B Klarskov, J Rosenberg
1Department of Surgical Gastroenterology 435, University of Copenhagen, Hvidovre Hospital, DK-2650 Hvidovre, Denmark. bisgaard@dadlnet.dk
Hypothesis:
Detailed information on duration and limiting factors for convalescence after uncomplicated laparoscopic cholecystectomy is lacking. Duration of convalescence may be associated with patients' expectations, given recommendations, and postoperative complaints such as pain and fatigue.
Design:
Prospective, descriptive study.
Setting:
A university hospital.
Patients:
Two hundred consecutive patients who underwent uncomplicated elective laparoscopic cholecystectomy.
Intervention:
For sedentary, light, or moderate workload or main recreational activity, we recommended 2 days of postoperative convalescence; for strenuous workload or recreational activity, we recommended 1 week.
Main Outcome Measures:
Duration and reasons for absence from work.
Results:
Convalescence from work (n = 85) and recreational activity (n = 198) was 6 days (range, 0-28 days) and 2 days (range, 0-24 days), respectively, in patients recommended for 2 days' convalescence. In patients recommended for 1 week of convalescence, convalescence from work (n = 25) was 10 days (range, 0-52 days), and convalescence from main recreational activity (n = 2), 8 days (range, 5-11 days). Among 87 patients who resumed work or activity later than recommended, pain was a contributory cause in 41 patients, fatigue in 35 patients, and convalescent period falling on a weekend in 26 patients, while 29 patients had arranged vacation or sick leave preoperatively. Preoperative expectation of convalescence and pain were independent contributory factors (P<.01) for convalescence from work for longer than 2 days in patients recommended for 2 days' convalescence.
Conclusions:
The period of convalescence after uncomplicated laparoscopic cholecystectomy is about 1 week from work and 2 days from recreational activity when 2 days of convalescence is recommended. Improved pain relief and patient information may further reduce convalescence.