A modified step-up approach to elective laparoscopic cholecystectomy yielded notable reductions in surgical consumables, achieving a 51.9% decrease in weight, a 50.6% drop in carbon footprint, and a 43.1% cost reduction. Implemented without extending operating time or increasing complications, this strategy highlights an effective method of minimizing waste in surgical practices. Patients treated with this […]
Category: Appendix, Gallbladder and Surgical Emergencies
Updated guidelines improve coagulation management in trauma care
A systematic review has led to updated clinical guidelines for inhospital coagulation management and fluid replacement therapy in patients with severe injuries. Key recommendations stress the importance of early interventions for trauma-induced coagulopathy and the use of viscoelastic assays to guide treatment. Notably, tranexamic acid should not be universally applied in emergency situations, as only […]
Elevated homocysteine levels predict small bowel necrosis.
Findings indicate that serum homocysteine levels serve as reliable predictors of irreversible transmural intestinal necrosis in patients with adhesive small bowel obstruction. Among 221 patients studied, those requiring surgical intervention exhibited markedly higher homocysteine, endotoxin, IL-5, IL-6, hs-CRP, IL-1β, and PCT levels. Notably, homocysteine demonstrated a sensitivity of 89.71% and specificity of 83.03%, outpacing other […]
Opioid use disorder increases healthcare costs for surgical patients
Emergency surgical patients with opioid use disorder (OUD) demonstrated significantly higher healthcare spending and utilization following discharge compared to those without OUD, indicating a heightened risk of complications. Analysis of 142,726 patients revealed that optimizing the use of opioid agonist treatment (OAT) preoperatively could enhance perioperative care and reduce costs. The findings highlight the critical […]
Structured prioritization significantly reduces surgery waiting times
Implementing a structured prioritization process in a tertiary emergency unit dramatically decreased median surgical waiting times from over 17 hours to under 9 hours. Compliance with acceptable waiting time windows also improved significantly, rising from 60.5% to 77.1%. This observational study analyzed 1851 non-elective surgeries in two periods, demonstrating that an urgency classification, kanban dashboard, […]
Complicated postoperative courses linked to specific risk factors.
A review of 901,205 laparoscopic cholecystectomy cases over 20 years revealed that 13% experienced complicated hospital stays. Key risk factors included older age, male gender, and acute conditions like cholecystitis. Complicated cases were more likely to require subtotal cholecystectomy or conversion to open surgery, leading to higher rates of common bile duct injury and mortality. […]
ERCP shows high success in managing traumatic pancreatic injuries
A systematic review revealed that endoscopic retrograde cholangiopancreatography (ERCP) achieves an impressive 89% success rate in treating traumatic pancreatic injuries (TPI). The procedure notably enhanced pancreatic duct integrity and led to lower complication rates (4-17%), primarily pancreatitis and bleeding. Mortality remained low at 3-5%, and ERCP significantly reduced hospital stays by an average of 3.1 […]
Laparoscopic appendectomy dominates treatment for acute appendicitis
In a comprehensive analysis of nearly 32,000 appendicitis cases in Germany, laparoscopic appendectomy emerged as the preferred surgical approach, conducted in 97% of cases by 2022. Complicated appendicitis was observed in 27.4% of patients, with variations in severity noted. Women showed a decreased likelihood of conversion to open surgery. The study highlighted that those who […]
Digital cholangioscopy is safer than surgery for Mirizzi syndrome
A multicenter study comparing digital single-operator cholangioscopy (DSOC) and surgery for Mirizzi syndrome reveals that despite lower technical success rates, DSOC significantly reduces overall and severe adverse events. Among 290 patients, those undergoing DSOC exhibited fewer complications and lower rates of conversion to open surgery and need for hepaticojejunostomy. These findings suggest that DSOC is […]
AI Revolutionizes Surgical Video Analysis in Cholecystectomy
AI algorithms were utilized to analyze 481 laparoscopic cholecystectomy videos, revealing that operative time elongated with case complexity. The study found that consultants had a longer duration of anatomy visualization compared to trainees, particularly in complex cases, with the cystic duct often identified before the cystic artery. By correlating AI-derived analytics with clinical variables, the […]