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A prehabilitation program including advice about diet, increased physical activity and cessation of smoking and drinking alcohol.

Routine care before the prehabilitation program was introduced

Routine care with mobilization the day after surgery

Prehabilitation concerning eating, smoking, drinking and physical activity

Prehabilitation

Routine care

Extra early mobilization

Standard mobilization

Open upper gastrointestinal surgery includes surgery in the upper abdomen such as ventricular, duodenal, pancreatic and biliary tract surgery. After upper abdominal surgery there is a risk of gastrointestinal and cardiopulmonary complications. There is currently insufficient knowledge about the effect of prehabilitation and extra early postoperative mobilization in upper pancreatic surgery.

This study's aim is to evaluate the effect of prehabilitation and extra early mobilization.

The study includes two substudies:

1. A prospective cohort of 75 patients undergoing pancreatic surgery after a prehabilitation program will be compared to 75 historical controls. Primary outcome is postoperative complications.
2. A randomized controlled trial based on 72 patients undergoing pancreatic studying the effect of extra early rehabilitation. The intervention group will be mobilized to bedside, standing or sitting in armchair \<6 hours after surgery, ie 3-4 hours after arrival at the Postoperative Department (PIVA). The control group will be mobilized according to routine i.e. the morning after surgery. Primary outcome is PaO2.

1. A prospective cohort compared to historical controls
2. A randomized, controlled, intervention study.

Effects of Prehabilitation and Early Mobilization for Patients Undergoing Pancreas Surgery.

Effekt av Prehabilitering Och Extra Tidig Mobilisering Efter öppen Pankreas Kirurgi

Standardized complications according to register

Quality of life, EORTC-QLQ-C30 (Range 30-124) Low values correspond to high quality of life

Quality of life QLQ-OG25 (Range 25- 100). Low values correspond to high quality of life

Quality of Life FA-R13 (range 12- 48). Low values correspond to high quality of life

Quality of recovery according to Allvin et al. 19 statements which are rated on a four grade scale fron no problem to major problem

Disease specific questionnaire, 8 statements rated on a visual analogue scale from 0 (no problem) to 10 (worst imaginable problem). Sum score are used for analysis (Range 0-80)

Study title	NCT ID	Conditions	Interventions	Eligibility	Organization	Link
Effects of Prehabilitation and Early Mobilization for Patients Undergoing Pancreas Surgery.	NCT03466593	Pancreas Cancer	Prehabilitation Routine care Extra early mob... Standard mobili...	-	Göteborg University
Effects of Prehabilitation and Early Mobilization for Patients Undergoing Pancreas Surgery.	NCT03466593	Pancreas Cancer	Prehabilitation Routine care Extra early mob... Standard mobili...	-	Göteborg University

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