A multicenter trial found that scheduled repeat imaging within 48-72 hours significantly aids in identifying complications in patients with moderate to high-grade blunt liver and spleen injuries. Of the 2,341 liver injury and 2,143 spleen injury patients observed, 35.1% and 27.9% underwent repeat imaging, respectively. Complications were detected in 7.1% of liver and 7.5% of […]
Category: Appendix, Gallbladder and Surgical Emergencies
AI model accurately assesses surgical skills in laparoscopic cholecystectomy
An AI-based surgical phase recognition model achieved 82.3% accuracy in assessing the skill levels of surgeons performing laparoscopic cholecystectomy. Novice surgeons demonstrated significantly longer dissection times compared to experts, with similar patterns observed in clipping and cutting tasks. The model proved effective in categorizing surgical proficiency, identifying key metrics such as phase duration and confidence […]
Operative treatment improves outcomes for acute cholecystitis in pregnancy
A systematic review and meta-analysis of nine studies involving 45,883 pregnant women found that operative treatment of acute cholecystitis significantly reduces adverse pregnancy outcomes and hospital stay length compared to nonoperative approaches. Specifically, the odds of negative outcomes were reduced by 40%, and the average hospital stay decreased by over seven days. Importantly, while maternal […]
Smoking increases surgical site infection risk in trauma patients
A significant association between smoking and surgical site infections (SSI) was identified in trauma patients, with 24.3% of those studied being smokers. Compared to nonsmokers, smokers had higher SSI rates (0.9% vs. 0.7%) and an increased risk persisted even after controlling for confounding factors. The strongest correlation was observed in patients with severe trauma. These […]
Dementia linked to worse surgical outcomes in older patients
In emergent hernia repair, patients with dementia, constituting 8.2% of 137,755 analyzed, face significantly higher risks. Older individuals with dementia experience increased in-hospital mortality (odds ratio 1.29), greater perioperative complications (1.41), and are more likely to be discharged non-home (2.98) compared to those without dementia. Additionally, readmission rates rise (1.11) for this vulnerable population. The […]
Modified approach slashes costs and carbon footprint in surgery
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 […]
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, […]