Subtotal cholecystectomy leads to a 13.3% chance of remnant cholecystitis, impacting surgical decision-making for complex cases. Cumulative incidence of remnant cholecystitis was 13.3% within 2 years, with most cases appearing within the first 6 months. Only 2.6% of patients required completion cholecystectomy, which was often performed open and linked to a 7.1% bile duct injury […]
Category: Appendix, Gallbladder and Surgical Emergencies
BMI Influences Postoperative Outcomes in Sepsis Surgeries
Older adults with sepsis undergoing emergency laparotomy show varied outcomes based on BMI, affecting surgical decision-making. 30-day mortality in this group is 31.6%. Obesity class II is linked to lower 30-day mortality (adjusted odds ratio 0.55) but increases risks of ventilator dependence >48 hours (1.48) and deep vein thrombosis (2.00). Obesity class III is tied […]
Omitting antibiotics in mild cholecystitis reduces unnecessary use.
Perioperative antibiotics did not significantly lower infectious complications: 9% with antibiotics vs. 12% without. Surgical site infections were also similar: 5% vs. 8%. Surgeons can consider forgoing antibiotics in healthy patients with mild-moderate acute cholecystitis. No differences in length of hospital stay or mortality were observed. Further research is needed for high-risk patient populations. Review […]
Delayed surgery worsens outcomes in adhesive small bowel obstruction.
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 […]
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 […]