Clinical Scorecard: Adherence to Early Postoperative Mobility and Identified Challenges in Patients Undergoing Hepatobiliary Surgery within an Enhanced Recovery After Surgery Protocol

At a Glance

Key Highlights

• 63.4% compliance with early ambulation protocol among patients.
• Compliance varied by procedure, from 80% after laparoscopic hepatectomy to 33.3% after biliary reconstruction.
• Common barriers to compliance included postoperative pain (46.3%) and fatigue/weakness (37.0%).
• Non-compliance associated with longer hospital stays and higher rates of complications.
• Factors linked to non-compliance included age, frailty, and the presence of multiple drainage tubes.

Guideline-Based Recommendations

Diagnosis

Management

• Initiate out-of-bed activity on the day of surgery and continue daily until discharge.

Monitoring & Follow-up

Risks

• Non-compliance linked to increased pulmonary complications and 30-day readmission rates.

Patient & Prescribing Data

320 consecutive adult patients undergoing elective hepatobiliary surgery.

Multimodal ERAS components including structured patient education and early ambulation.

Clinical Best Practices

• Implement targeted strategies to mitigate barriers to early ambulation.
• Consider patient-level factors such as frailty and support systems in postoperative care.

Related Resources & Content

• ERAS Society guideline for liver surgery