Accelerating Postoperative Recovery: The Impact of Early Mobility Protocols in Surgical Intensive Care Unit (SICU) Patients After Open Cholecystectomy

TL;DR

Early mobility exercises after open cholecystectomy improve recovery, mobility, and independence in patients.

Contribution

A structured early mobility protocol significantly enhances postoperative recovery in open cholecystectomy patients.

Findings

83.3% of patients in the experimental group achieved moderate mobility by the fourth postoperative day.

The experimental group showed a 4.67 mean improvement in mobility scores compared to 0.24 in the control group.

Functional independence scores increased by 19.08 in the experimental group (p < 0.001).

Abstract

Background

Diseases of the biliary system and gallbladder pose a significant global public health burden, affecting millions annually. Conditions such as gallstone formation, cholecystitis, and biliary dysfunction contribute to gastrointestinal morbidity, often necessitating surgical intervention. Gallstone prevalence ranges between 10% and 15%, with post-surgical recovery in open cholecystectomy patients being hindered by limited mobility, leading to prolonged hospital stays. This study investigates the impact of implementing an early mobility protocol on postoperative recovery in patients who have undergone open cholecystectomy.

Methods

This study included a total of 24 patients who underwent open cholecystectomy, who were randomly assigned to two groups, with 12 participants in each. Baseline demographic and clinical characteristics, including age, gender, education level, religion, body mass index (BMI), and preoperative pain scores, were systematically documented to ensure comparability between the groups. The experimental group followed a structured early mobility protocol, consisting of supervised mobility exercises such as sitting, standing, breathing exercises, abdominal exercises, and short-distance ambulation, conducted twice daily from the first postoperative day until the fourth day. In contrast, the control group received standard postoperative nursing care without additional mobility interventions. Recovery outcomes, including mobility levels, functional independence, and patient satisfaction, were evaluated using validated assessment scales. Statistical analyses were performed using SPSS version 28.0 (IBM Corp., Armonk, NY, USA).

Results

Prior to the intervention, all patients exhibited complete dependence on mobility. Following the intervention, 83.3% of patients in the experimental group attained moderate mobility, with 58.3% achieving partial functional independence by the fourth postoperative day (p < 0.001). The experimental group demonstrated a mean improvement in mobility scores of 4.67, significantly higher than the 0.24 mean improvement in the control group (p < 0.001). Functional independence scores in the experimental group increased by a mean difference of 19.08 (p < 0.001). A strong positive correlation was observed between mobility and functional independence (r = 0.744, p < 0.01), reinforcing the efficacy of early mobilization.

Conclusion

The implementation of an early mobility protocol significantly improved mobility, functional independence, and patient satisfaction in open cholecystectomy patients, demonstrating its importance in postoperative care. The protocol’s effectiveness was consistent across different demographic variables, suggesting broad applicability. Larger studies are recommended to further validate these findings.