In a study comparing visual endoscopic retrograde appendicitis therapy (v-erat) with antibiotic therapy for uncomplicated appendicitis, no significant difference was found in treatment success rates (93.6% vs 90.5%). However, v-erat notably lowered appendicitis recurrence risk and appendectomy rates during initial hospitalization (4.3% vs 9.5%). Additionally, patients undergoing v-erat experienced a shorter hospital stay (3 days […]
Category: Appendix, Gallbladder and Surgical Emergencies
Specialization in colorectal surgery improves patient outcomes
Emergency colorectal surgeries performed by specialized surgeons significantly lower 30-day and in-hospital mortality rates. Results from 21 studies indicate a marked increase in primary anastomosis and laparoscopic procedure rates among colorectal specialists, alongside a reduction in stoma formation. The findings, though subject to variability in patient demographics and definitions of specialization globally, emphasize the critical […]
High prevalence of Rouvière’s sulcus may reduce bile duct injuries
An analysis of 111 patients reveals that Rouvière’s sulcus (RS) is present in 83.8% of cases, with significant variations classified under Singh-Prasad and Dahmane systems. Specifically, 48.4% of patients exhibit Singh-Prasad type 1a. The high occurrence of RS suggests it can serve as a crucial anatomical landmark during laparoscopic cholecystectomy, potentially mitigating the risk of […]
Optimal haemostatic clip usage in laparoscopic cholecystectomy identified
A precise control pathway for haemostatic clip usage during laparoscopic cholecystectomy was established based on patient variations. Key factors affecting clip consumption included acute cholecystitis, anatomical variation, and severe adhesions. The study revealed that the optimal usage included no more than three clips in 17.3% of cases, four clips in 81.72%, and five or more […]
Cost-effective silicone model enhances laparoscopic appendectomy training
A novel silicone-based training model for laparoscopic appendectomy was developed, combining clinical and engineering insights. Iteratively refined through four stages and stakeholder consensus, the model closely mimics anatomical structures and provides realistic haptic feedback. At a cost of only €9.67, it is scalable for various laparoscopic box trainers. This approach facilitates residents’ skill acquisition in […]
Oral antibiotics may replace surgery for uncomplicated appendicitis.
A clinical trial is set to evaluate the efficacy of oral moxifloxacin versus placebo in treating uncomplicated acute appendicitis without hospitalization. Targeting adults aged 18-60, the APPAC IV trial will assess treatment success 30 days post-discharge, aiming to determine if antibiotics and inpatient care can be safely eliminated. This noninferiority trial, conducted across nine Finnish […]
Primary anastomosis shows better outcomes in sigmoid volvulus surgery
In a comprehensive analysis of 1,083 sigmoid volvulus cases treated over 58 years, primary anastomosis emerged as the superior technique compared to stoma creation following urgent sigmoidectomy. Key findings include significantly lower complication rates, shorter hospitalization durations, and reduced costs associated with primary anastomosis. Notably, patients undergoing primary anastomosis experienced fewer incidents of shock, bowel […]
Immature granulocyte percentage effectively predicts complicated appendicitis.
A study revealed that the immature granulocyte percentage serves as a reliable biomarker for distinguishing complicated from uncomplicated acute appendicitis. With a specificity of 92% at a cut-off value of 0.6, this biomarker outperformed other indicators, such as the immature granulocyte count and procalcitonin levels. Data collection involved patients diagnosed with appendicitis over a year, […]
Increased frailty elevates postoperative complication rates in surgery
A study involving 733 patients undergoing major emergency abdominal surgery found that frailty significantly impacts postoperative complications. Patients with low frailty (CFS 1-3) experienced 140 complications per 100 patients, compared to 267 for moderate (CFS 4-6) and 297 for high frailty (CFS 7-9), revealing a strong correlation between higher frailty scores and increased complication severity, […]
Risk factors identified for bail-out procedures in cholecystitis
In a cohort of 728 patients with acute cholecystitis, 69 (9%) underwent bail-out procedures (bop), comprising 34 laparoscopic and 35 open approaches. Key predictors for requiring a bop included elevated admission total bilirubin levels. Notably, laparoscopic bop demonstrated similar complication rates to open procedures while offering reduced hospital stays, thereby contesting the traditional view that […]