Splenic artery embolization (SAE) demonstrates high efficacy in preserving the spleen during treatment of grade III-V splenic injuries. Notably, timing is crucial; earlier embolization correlates with better outcomes. In a study of 400 patients, both SAE (98.2% preservation) and nonoperative observation (97.7%) achieved significant success. Factors influencing embolization effectiveness include cranial AIS scores and the […]
Category: Appendix, Gallbladder and Surgical Emergencies
Low Skeletal Muscle Gauge Elevates Mortality Risk After Emergency Laparotomy
Low skeletal muscle gauge (SMG) significantly predicts higher 30-day and 90-day mortality following emergency laparotomy, with odds ratios of 2.12 and 2.64, respectively. Patients presenting with acute abdominal pain should undergo routine computed tomography reporting of body composition, as low SMG also correlates with prolonged hospital stays. With a study cohort of 1,090 patients, this […]
Early VTE Prophylaxis Cuts Risk of Complications in Major Trauma Patients
Initiating pharmacologic venous thromboembolism (VTE) prophylaxis within 24 hours of major trauma admission dramatically lowers VTE risk by 42%, according to a large cohort study. Among 6,569 patients, those receiving early treatment experienced significantly fewer VTE events (2.8% compared to 7.8%) and showed reduced mortality rates (0.6% vs. 1.8%). Crucially, early initiation did not increase […]
Prehospital GCS Scores Predict Trauma Mortality Effectively
Early assessment using the Glasgow Coma Scale motor score proves crucial for predicting mortality outcomes after trauma. A machine-learning model analyzing factors within three hours, 24 hours, and 30 days highlights the initial GCS motor score and worst GCS as consistent mortality predictors. Their efficacy spans the leading causes of death, including traumatic brain injury […]
Mini-laparoscopic cholecystectomy excels in obese patients
Mini-laparoscopic cholecystectomy (mlc) using a 5 mm umbilical port significantly improves outcomes for obese patients with gallstones. The mlc group experienced no port-site hernias, shorter operative times (46 minutes vs. 52), less postoperative pain, and a quicker return to daily activities. Patient satisfaction surged while in-hospital analgesic needs dropped. However, surgeon satisfaction dipped slightly with […]
Robotic Cholecystectomy Proves Safe for High-Risk Patients
Robotic cholecystectomy demonstrates safety and efficacy across various gallbladder pathologies in high-comorbidity patients, both elective and emergent. An analysis of 218 cases at a tertiary care facility from June 2020 to October 2023 revealed a 30-day complication rate of just 7.3%, with no bile duct injuries reported. Postoperative issues were primarily related to sickle cell […]
Indocyanine Green Enhances Safety in Complex Liver Surgery
Anatomical segmentectomy of the liver using indocyanine green (ICG) fluorescence imaging significantly improves outcomes in cases of iatrogenic bile duct injury and recurrent cholangitis. A 46-year-old patient underwent surgical resection with ICG aiding in precise tissue identification and visualization, resulting in a successful procedure without bile leaks. Enhanced imaging of atrophic regions and abnormal biliary […]
Machine Learning Nomogram Predicts Laparoscopic Surgery Difficulty
A novel machine learning-based nomogram accurately predicts the surgical difficulty of laparoscopic cholecystectomy in gallstone patients. By analyzing 362 cases, the model integrated critical clinical and inflammatory indicators, achieving an impressive AUC of 0.863 in the validation set. This predictive capability enhances surgical planning and optimizes patient outcomes, encouraging a shift toward data-driven decision-making in […]
Male Sex and Acute Cholecystitis Raise Bile Duct Injury Risk
Male sex and acute cholecystitis significantly elevate the risk of bile duct injury during cholecystectomy, with adjusted odds ratios of 1.27 and 1.74, respectively. The meta-analysis, examining over 6.5 million surgeries, also found inconsistent documentation of the critical view of safety, which lacked a statistical link to reduced injury rates. Routine use of intraoperative cholangiograms […]
Acute Pancreatitis Hospitalizations Decline Amid COVID-19 in Japan
In 2021, Japan saw a significant drop in acute pancreatitis (AP) hospitalizations, declining to 61,080 cases from 78,450 in 2016, marking a 49 per 100,000 incidence rate. The mortality rate among severe cases improved to 5.3%, down from 6.1%. Treatment adherence improved; 61.2% of patients received antibiotics and 56.9% of severe cases benefited from enteral […]