Recovery after uncomplicated laparoscopic cholecystectomy.
BACKGROUND
After laparoscopic cholecystectomy, the duration of convalescence is 2 to 3 weeks with an unclear pathogenesis. This study was undertaken to analyze postoperative recovery after uncomplicated elective laparoscopic cholecystectomy.


METHODS
Twenty-four consecutive unselected employed patients were followed up prospectively from 1 week before to 1 week after outpatient laparoscopic cholecystectomy. Daily computerized monitoring of physical motor activity and sleep duration and night sleep fragmentation (actigraphy), subjective sleep quality, pulmonary function, pain, and fatigue were registered. Treadmill exercise performance (preoperatively and at postoperative days 2 and 8) and nocturnal pulse oximetry at the patients' homes (preoperatively and postoperative nights 1-3) were completed.


RESULTS
Median age was 41 years (range, 21-56). Compared with preoperatively, levels of physical motor activity, fatigue, and pain scores were normalized 2 days after operation. Subjective sleep quality was significantly worsened on the first postoperative night, and sleep duration was significantly increased on the first 2 postoperative nights. There were no significant perioperative changes in actigraphy night sleep fragmentation, incidence of self-reported awakenings or nightmares/distressing dreams, exercise performance, or nocturnal oxygenation. Pulmonary peak flow measurements were normalized the day after operation.


CONCLUSIONS
After uncomplicated outpatient laparoscopic cholecystectomy, there is no pathophysiologic basis for recommending a postoperative convalescence of more than 2 to 3 days in otherwise healthy younger patients.
Bisgaard
Thue
T
Department of Surgical Gastroenterology, University of Copenhagen, Hvidovre, Denmark.
Klarskov
Birthe
B
Kehlet
Henrik
H
Rosenberg
Jacob
J
D000328:Adult; D017081:Cholecystectomy, Laparoscopic / Q000009:adverse effects; D002940:Circadian Rhythm; D004651:Employment; D015444:Exercise; D005221:Fatigue / Q000209:etiology; D005260:Female; D005767:Gastrointestinal Diseases / Q000209:etiology; D006801:Humans; D008168:Lung / Q000503:physiopathology; D008297:Male; D008875:Middle Aged; D009043:Motor Activity / Q000502:physiology; D010092:Oximetry; D010149:Postoperative Pain / Q000503:physiopathology; D020127:Recovery of Function; D011998:Recreation; D012129:Respiratory Function Tests