Antibiotics provide a reliable option for adults with uncomplicated acute appendicitis, showing long-term effectiveness. After 10 years, 37.8% of patients treated with antibiotics experienced appendicitis recurrence, and 44.3% underwent appendectomy. Complication rates were significantly lower with antibiotics (8.5%) versus surgery (27.4%). Quality of life outcomes were similar, indicating antibiotics do not compromise patient wellbeing. Surgeons […]
Category: Appendix, Gallbladder and Surgical Emergencies
Barbed sutures are safe for intra-abdominal surgery, showing no link to intestinal obstruction.
In a study of over 20,000 patients, only 1.3% experienced postoperative intestinal obstruction, with no cases tied to barbed sutures. Among the 102 patients who underwent reoperation for obstruction, none were related to suture entrapment. Surgeons can confidently use barbed sutures without fearing increased risk of intestinal complications. 12.3% of patients were readmitted for various […]
Laparoscopic vs. Robotic Cholecystectomy: Key Insights
Surgeons should weigh the nuanced benefits and risks of robotic and laparoscopic cholecystectomy for gallstone disease. Robotic cholecystectomy (RC) has longer operative times, especially in Western centers (75 vs. 60 minutes). There’s a higher rate of bile duct injury with RC (0.72% vs. 0.23%), though early learning curves may play a role. RC shows reduced […]
Laparoscopic bile duct exploration proves safe and effective for stones
Laparoscopic common bile duct exploration (LCBDE) offers surgeons a reliable way to manage bile duct stones with promising outcomes. In a study of 1,689 patients, the overall conversion rate to open surgery was just 5%. Success rates were high: 77.6% for trans-cystic LCBDE and 93.4% for trans-choledochal LCBDE. Bile leak rates were notably lower for […]
Endoscopic Therapy Shows 16.1% Recurrence in Appendicitis
Endoscopic retrograde appendicitis therapy (ERAT) is effective but carries a 16.1% risk of recurrence within a year. Technical success was 100%, with a 92.4% clinical improvement rate in 435 patients. Key predictors of recurrence include age over 60 (OR=2.981), previous appendicitis, and the presence of appendicoliths. Surgeons should prioritize ERAT for low-risk patients and utilize […]
New Nomogram Predicts Spontaneous Closure in Duodenal Fistulas
A newly developed nomogram predicts spontaneous closure in septic patients with external duodenal fistulas post-infection control, critical for surgery decisions. Spontaneous closure rates after infection control were 53.2% in the development cohort and 57% in validation. Six key factors were identified: time to infection control, infection extent, emergency surgery, fistula size, duodenal decompression, and albumin […]
High Appendiceal Neoplasm Rate in Complicated Appendicitis
Patients with complicated appendicitis show a 16.1% rate of appendiceal neoplasms, necessitating careful evaluation before surgical intervention. Among 387 complicated appendicitis cases, 304 had surgery; the majority (78.6%) were surgically treated. Neoplasm rates varied: mucocele cases saw the highest at 58%, while perforated appendicitis was at 12%. Consider age, appendiceal diameter, and lymphadenopathy when assessing […]
Laparoscopic Appendectomy Beats Open Surgery in Africa
Laparoscopic appendectomy reduces complications for acute appendicitis in Sub-Saharan Africa, offering a safer option for surgeons. Laparoscopic appendectomy lowers the risk of surgical site infections by 60% (risk ratio 0.40). It also leads to shorter hospital stays compared to open surgery. Surgeons should consider adopting laparoscopic techniques where feasible to improve patient outcomes. Cost-effectiveness is […]
Automated Trauma Video Review Enhances Patient Assessment
A computer vision model could revolutionize trauma video review by automating the identification of key phases and procedures, improving trauma care quality. Achieved 98.3% frame-wise accuracy and high edit and F1 scores (up to 94.5%) for trauma resuscitation phases. Procedure detection accuracy surpassed 66% for x-rays and central line placements. This technology can enhance surgical […]
Early Cholecystectomy Lowers Stay in Mild Acute Pancreatitis
Early laparoscopic cholecystectomy in mild acute biliary pancreatitis patients significantly improves outcomes. Early surgery (within 72 hours) cuts hospital stay to 5 days vs. 7 days (p < 0.05). Procedure time is shorter: 61.87 minutes vs. 66.77 minutes (p < 0.05). Implementing early cholecystectomy can streamline surgical workflows without raising complication risks. No differences in […]