Early mortality rises with surgical delay: 3.6% (0-1 days) to 7.1% (≥9 days). Bowel resection rates increase from 18.0% to 24.5% as delays lengthen. Timely surgical intervention is critical to improve patient survival and reduce long-term recurrence rates. Non-operative treatment leads to recurrence in 23.5% vs. 8.8% for surgical patients; laparoscopic surgery further lowers recurrence […]
Category: Appendix, Gallbladder and Surgical Emergencies
New Insights on Appendiceal Tumors with AOM in Appendicitis
Antibiotic-only management for acute appendicitis is generally safe, but requires vigilance for missed tumors. In a study of 2,293 appendectomies, only 1.6% had malignant lesions, most being low-grade neuroendocrine tumors under 2 cm. Aggressive tumors were mostly found in older patients with prolonged symptoms and larger appendiceal diameters. Surgical criteria can help identify low-risk candidates […]
Survey Reveals Gaps in Acute Appendicitis Training
Training for acute appendicitis is inconsistent across hospitals, impacting surgeon readiness. 85% of trainees lack structured competency assessments. Surgeons increasingly opt for laparoscopic techniques, rising significantly from 2022 to 2025. Consider implementing routine feedback and standardized assessments to improve surgical readiness. Only 55% of trainees used a simulator before their first laparoscopic appendectomy, highlighting a […]
Prehospital Whole Blood Transfusion Not Superior in Trauma
Prehospital whole-blood transfusion does not improve outcomes for major traumatic hemorrhage compared to standard blood component therapy. In a study of 616 patients, 48.7% in the whole-blood group and 47.7% in standard care experienced death or massive transfusion within 24 hours (p=0.84). Serious adverse events occurred more frequently in the standard-care group (37 vs. 31 […]
Pre-hospital deaths dominate trauma fatalities in urban systems
Most trauma deaths happen before hospital arrival, highlighting urgent needs in trauma care. Of 3,089 adult trauma patients, 497 (16.1%) died; 77.1% died pre-hospital, typically within 12 minutes of injury. Hemorrhage and traumatic brain injury accounted for 81.9% of deaths, with 96.2% of hemorrhage deaths occurring pre-hospital. Surgeons should focus on improving pre-hospital interventions to […]
Whole-blood transfusion cuts mortality in civilian trauma cases
Whole-blood transfusion significantly reduces mortality in adult trauma patients compared to component therapy, especially in civilian settings. 24-hour mortality odds ratio for whole-blood vs. component therapy: 0.76 (95% CI, 0.60-0.95). Civilian data shows absolute risk reduction of 4.6% with whole-blood (n=39,028), and a 30-day mortality odds ratio of 0.76 (95% CI, 0.60-0.98). Surgeons should consider […]
Laparoscopic Ultrasound During Emergency Cholecystectomy Cuts Costs
Using laparoscopic ultrasonography during emergency laparoscopic cholecystectomy for severe calculous cholecystitis can reduce hospital stays and costs. Patients undergoing emergency surgery with ultrasonography had a significantly shorter hospital stay compared to those who underwent routine surgery after imaging. Hospitalization costs were also lower for the emergency group without increased complications. Surgeons should consider this approach […]
Large Language Models Improve Trauma Triage Accuracy
Large language models enhance prehospital trauma triage, potentially improving patient outcomes. LLMs achieved 83.5% triage accuracy, outperforming human clinicians’ 78.9% accuracy (p<0.01). Under-triage with LLMs improved slightly to 4.8%, compared to 5.1% with human triage (p=0.73). Essential transcripts reduced communication length by 80.8% while maintaining accuracy. Integrating LLMs in trauma assessment can lead to better […]
Emergency Surgery Outcomes Worse at Non-Transplant Centers
Emergency surgeries in solid-organ transplant patients fare worse at non-transplant centers, particularly for kidney transplants. Among 2,679 cases, 30-day mortality was 4%, with 31% facing complications or mortality. Kidney transplant patients showed 3.52 times higher mortality at academic centers compared to transplant centers. Urgent surgical care for transplant patients should prioritize treatment at transplant centers […]
AI Platform Boosts Safety in Laparoscopic Cholecystectomy
An AI-based tool shows promise in improving the critical view of safety during laparoscopic cholecystectomy, reducing bile duct injury risks. The AI platform achieved impressive accuracy scores: 0.91 for CVS I, 0.86 for CVS II, and 0.73 for CVS III. Significant improvement in CVS assessment was observed post-deployment (p < 0.01). Surgeons reported high satisfaction, […]