Major trauma patients fare better at tertiary trauma centers due to critical interventions. In-hospital mortality is 5.65% at tertiary centers vs. 7.04% at non-tertiary centers (risk ratio 1.25). Key factors contributing to lower mortality include massive blood transfusions (45.67%) and effective hemorrhage control through laparotomy (30.13%). Surgeons should focus on implementing these interventions to enhance […]

New research identifies the best scoring system to predict outcomes in emergency laparotomy patients. The NELA score shows the highest accuracy for 30-day mortality with a c-statistic of 0.979. The Hajibandeh index excels in sensing surgical site infections (0.760) and anastomotic leaks (0.741). The P-POSSUM score is most specific for predicting re-exploration, aiding in surgical […]

A large study reveals CT findings that predict complicated acute appendicitis, which may influence treatment choices. Wider appendiceal diameter and wall enhancement defects correlate with a higher risk of complications (p < 0.001). In patients without an appendicolith, wall enhancement defects show an odds ratio of 3.39 for complications. Surgeons should consider these imaging markers […]

Transcylindrical cholecystectomy offers a promising outpatient option for treating cholelithiasis with minimal complications. Operative time averages 40 minutes with a low conversion rate of 0.9%. Complication rates include 2.2% wound infections, 0.5% bile leaks, and 0.1% mortality. Most patients (78%) report good to excellent condition within 24 hours. Consider this technique for low-risk patients, particularly […]

Surgeons can confidently perform proactive emergency laparoscopic cholecystectomy for complex acute cholecystitis, showing strong outcomes even in high-risk patients. Among 721 patients, the overall complication rate was just 6.9%, with severe complications at 1.2%. Patients older than 80 had no higher complication rates (p = 0.14) compared to younger patients. Indocyanine green cholangiography significantly reduced […]

Preoperative C-reactive protein (CRP) can help predict complications and the need for conversion in laparoscopic cholecystectomy for acute cholecystitis. Acute cholecystitis patients showed CRP levels at 25.4 mg/l, compared to 7.1 mg/l in chronic cases (p < 0.001). CRP reliably predicted conversion to open surgery with an area under the curve (AUC) of 0.964 and […]

Enhanced recovery after surgery (ERAS) protocols accelerate recovery in elderly patients undergoing emergency surgery for perforated peptic ulcers. ERAS patients achieved bowel movement in 1.21 days vs. 2.20 days (p=0.008) and mobilized faster (1.26 vs. 3.51 days, p<0.001). Hospital stays were significantly shorter: 5.24 days vs. 7.03 days (p=0.001). Implementing ERAS led to better pain […]

Trauma center distribution matters: regions with more centers have better patient outcomes and lower economic costs related to injuries. Higher density of trauma centers correlates with lower per capita costs for fatal injuries. The northeast has the lowest burden of fatalities and years of potential life lost, while the south, with the fewest centers, faces […]