Synapse
⌘+K
Synapse
PulseExploreClubsResearchersJournals
Instagram
HomeClubsExplore
June 27, 2026Frontiers in SurgeryOpen Access

Open or major hepatobiliary surgery linked to ~253% higher odds of early postoperative ambulation non-compliance.

View Full Paper
Ask AI
Bookmark
Share

Why the study?

Real-world compliance with early postoperative ambulation in hepatobiliary surgery ERAS pathways is variable, and patient-level barriers remain incompletely characterised.

Population

320 adult patients undergoing elective hepatobiliary surgery under an ERAS pathway

Comparison

Compliant vs non-compliant with early ambulation protocol

Design

Retrospective cohort study

Follow-up

30 days

Key result

Open or major hepatobiliary surgery significantly increased the odds of non-compliance with early postoperative ambulation (aOR 3.53), alongside multiple drains, frailty, older age, and lack of family companionship.

Authors

YZY ZhangJGJingyan GuJSJie Song

Discussion

Loading...

Member takes

Overview

Patients after major hepatobiliary surgery may require targeted adherence support; leaves open whether compliance improves outcomes in prospective trials.

Key Points

  • This study aims to evaluate compliance with early postoperative ambulation in hepatobiliary surgery patients and identify associated barriers.
  • Retrospective review of records for 320 adult patients who underwent elective hepatobiliary surgery following ERAS protocol.
  • Compliance was defined by ambulation criteria on postoperative days and barriers were assessed via nursing assessment questionnaires.
  • Statistical analyses included univariable comparisons and multivariable logistic regression adjusted for relevant clinical predictors.
  • 63.4% of patients were compliant with early ambulation, varying by surgical procedure.
  • Patient-reported barriers included pain (46.3%), fatigue (37.0%), and knowledge deficit (35.6%).
  • Non-compliance linked to longer hospital stays (11.9 vs. 7.5 days, P<0.001) and higher complication rates (23.9% vs. 7.4%, P<0.001).

Study Design

Type

Cohort (n=320)

Multicenter

No

Structured PICO

P
Population
320 adult patients undergoing elective hepatobiliary surgery within an ERAS pathway, retrospectively analyzed to determine compliance with early postoperative ambulation and its associated barriers.
E
Exposure
Compliance with early ambulation protocol (out-of-bed activity by postoperative day 1 and ambulation distance ≥30 m by postoperative day 2) within an ERAS framework.
C
Comparator
Non-compliance with the early ambulation protocol.
O
Outcome
Compliance status with the early ambulation protocol.

Main Result

Odds Ratio: 3.53 (95% CI 1.92–6.48)

p-value: p=<0.001

In hepatobiliary surgery patients, compliance with early ambulation is approximately 63% and is hindered by surgical magnitude, drainage burden, frailty, age, and lack of family companionship.

Limitations

  • Retrospective observational design precludes causal inference
  • Single-centre cohort limits generalizability
  • Barrier questionnaire lacks formal psychometric validation in a separate cohort
  • Potential residual confounding by unmeasured variables such as provider behavior and patient motivation
  • observational design does not permit causal inference
  • barrier questionnaire has not undergone formal psychometric validation in a separate cohort
  • single-centre retrospective study

Cite This Study

Zhang et al. (2026) conducted a cohort in Hepatobiliary surgery (n=320). Open or major hepatobiliary surgery vs. Minimally invasive or minor hepatobiliary surgery was evaluated on Non-compliance with early ambulation protocol (out-of-bed activity by POD 1 and ambulation distance ≥ 30 m by POD 2) (aOR 3.53, 95% CI 1.92-6.48, p=<0.001). Open or major hepatobiliary surgery significantly increased the odds of non-compliance with early postoperative ambulation (aOR 3.53), alongside multiple drains, frailty, older age, and lack of family companionship.

synapsesocial.com/papers/6a3f9785125782b61d865748https://doi.org/10.3389/fsurg.2026.1874831
View Full Paper
Ask AI
Bookmark
Share