A quality improvement initiative across eight teaching hospitals significantly reduced percutaneous cholecystostomy usage for acute calculous cholecystitis, dropping from 9.7% to 7.2%. Post-implementation data indicated a decrease in 30-day mortality (odds ratio 0.60) and increased laparoscopic cholecystectomy rates (94.5% to 96.3%). Although minor bile duct leaks rose from 0.9% to 2.1%, no major duct injuries […]

In a comparison of pain management techniques, intercostal nerve block combined with incisional infiltration anesthesia significantly alleviated postoperative pain in laparoscopic cholecystectomy patients. The intervention group reported lower pain scores at all measured intervals, evidencing less reliance on additional tramadol. Furthermore, patients in the intervention group experienced shorter hospital stays and quicker ambulation without compromising […]

From 1999 to 2020, appendicitis-related mortality decreased overall but revealed significant disparities. The age-adjusted mortality rate fell from 0.38 to 0.32 per 100,000, with a notable decline for males but a concerning rise for females since 2016. Black individuals had the highest mortality rates, although significant declines were observed across racial groups. Nonmetropolitan regions experienced […]

Analysis of statewide discharge data shows that trauma centers significantly reduce risk-adjusted mortality rates and complications, such as acute kidney injury and pulmonary embolism, compared to non-trauma facilities. However, they report higher rates of ventilator-associated pneumonia and surgical site infections. Notably, while trauma centers predominantly treat pediatric patients and those with severe injuries, geriatric patients […]

A systematic review of 11 studies involving 8,361 participants demonstrates that shorter intravenous antibiotic courses (2-6 days) are non-inferior to longer regimens for preventing infections after complicated appendicitis. Early transitions to oral antibiotics also show effectiveness, reducing hospital stays and healthcare costs. Key risk factors affecting antibiotic duration include disease severity and surgical complexity. The […]

Advancements in massive transfusion protocols (MTPs) highlight the importance of balanced transfusion strategies, utilizing a 1:1:1 ratio of plasma, platelets, and red blood cells. This approach significantly enhances early hemorrhage control, though challenges persist with individual patient variability. Viscoelastic hemostatic assays facilitate personalized treatment by providing real-time clot assessments. Renewed interest in whole blood transfusions, […]

A Delphi survey revealed 37 essential variables for adult trauma registries in low-middle-income countries, with demographic data, injury details, and clinical assessments leading the list. Following a two-round expert consensus process, additional optional variables emerged, including education and income levels. Birthplace was excluded. These insights aim to enhance trauma care in resource-constrained settings, emphasizing the […]

A scoping review of 39 studies on acute mesenteric ischaemia indicated that endovascular interventions significantly improved patient outcomes. Notably, they showed lower 30-day mortality rates compared to open surgery, ranging from 0% to 53.8% versus 21% to 81%. Additionally, patients receiving endovascular treatment experienced shorter hospital and ICU stays. However, delays in diagnosis, averaging between […]