Preoperative education in cholecystectomy in the context of a multimodal protocol of perioperative care: a randomized, controlled trial

World J Surg. 2014 Feb;38(2):357-62. doi: 10.1007/s00268-013-2255-7.


Background: Preoperative education is a key point in multimodal protocols of perioperative care. We investigated whether preoperative education for patients undergoing open cholecystectomy would reduce the incidence of perioperative symptoms.

Methods: This was a randomized, single-blinded, clinical trial that included adult (18-65 years old) candidates for elective open cholecystectomy. All patients took part in the ERAS/ACERTO protocol of perioperative care except that only the intervention group received preoperative education. The main endpoints of the study were the presence and intensity of postoperative symptoms (e.g., nausea, vomiting, pain) measured by a visual analogue scale, 24 h after the operation.

Results: A total of 74 patients (34 in the intervention group, 40 in the control group) completed the study. The intervention group had significantly lower median (interquartile range) scores for nausea [0 (4) vs. 2.5 (5.8), p = 0.04] and pain [0.2 (2.3) vs. 3.1 (3.45), p < 0.01] than the controls. High well-being (score ≥ 6) was reported by 79.4 % (27 patients) of the intervention group in contrast to 57.5 % (23 patients) of the controls (p = 0.04).

Conclusions: Preoperative education is highly effective in the context of a multimodal protocol for enhancing the recovery of patients submitted to open cholecystectomy.

Publication types

  • Randomized Controlled Trial
  • Research Support, Non-U.S. Gov't

MeSH terms

  • Adolescent
  • Adult
  • Aged
  • Cholecystectomy* / adverse effects
  • Cholecystectomy* / education
  • Clinical Protocols*
  • Female
  • Humans
  • Male
  • Middle Aged
  • Perioperative Care / standards*
  • Postoperative Complications / prevention & control
  • Postoperative Nausea and Vomiting / epidemiology
  • Young Adult