An international survey involving 1,042 healthcare practitioners highlighted significant knowledge gaps regarding intra-abdominal hypertension (IAH) and abdominal compartment syndrome (ACS) guidelines. While there was general agreement on most existing statements, critical new candidate statements failed to achieve consensus, with only 77% acceptance of normal intra-abdominal pressure levels. Notably, less than 60% of respondents were aware […]
Category: Appendix, Gallbladder and Surgical Emergencies
Pre-operative evaluation reduces complications in gallstone surgeries
In a retrospective analysis of 5,450 cholecystectomies, findings indicated that thorough pre-operative evaluation significantly minimizes perioperative complications and unexpected histopathological outcomes. The laparoscopic to open conversion rate was low at 1.2%, primarily due to unclear anatomy, while bile duct injury occurred in only 0.11% of cases. The incidence of incidental carcinoma gall bladder was 0.3%, […]
Asymptomatic cholecystitis requires improved surgical strategies
Asymptomatic cholecystitis is prevalent yet often overlooked, with 80% of cases lacking clinical manifestations. Surgeons frequently avoid addressing this condition, leading to inconsistencies in treatment approaches and increased risks, such as postcholecystectomy syndrome. The current literature is sparse and fragmented, lacking a unified strategy for managing asymptomatic cases. A comprehensive examination of the tactical approaches […]
Percutaneous cholecystostomy enhances surgical outcomes in elderly patients.
In a study involving octogenarians with acute cholecystitis, percutaneous cholecystostomy (PC) improved preoperative conditions, including systemic inflammation and blood coagulation abnormalities, compared to upfront surgery (US). Patients undergoing PC had worse initial health status but exhibited higher elective surgery rates post-treatment. Remarkably, despite the complexity of cases, surgical quality indicators such as conversion rates and […]
Rural Riyadh Faces Critical Trauma Care Deficiencies
The investigation highlights severe inadequacies in trauma care in rural Riyadh, where no level 1 trauma centers exist. The majority of trauma cases (67.7%) fell under critical conditions labeled as red criteria, with al-Kharj identified as the most affected area. Blunt injuries were prevalent, accounting for 79.4% of cases. Alarmingly, 38.2% of critical cases experienced […]
Emergency colorectal cancer patients in Nigeria have worse survival outcomes
Among 535 colorectal cancer patients in Nigeria, 30.7% presented emergently, often with more advanced disease. Emergency presentations were linked to significantly poorer overall survival, median survival being 6.4 months compared to 17.4 months for elective patients. Factors such as lower household income and education level were prevalent in the emergency group. Although surgery improved survival […]
Society of Radiologists in Ultrasound (SRU) guidelines reduce gallbladder surgery and costs significantly
A comparison of clinical guidelines for managing gallbladder polyps reveals marked differences in recommended actions. Researchers found that adherence to Society of Radiologists in Ultrasound (SRU) guidelines resulted in 16.9% of patients undergoing immediate surgery compared to 52.5% under European guidelines. Additionally, the SRU approach suggested ultrasound as a reasonable next step for 42.4% versus […]
Frailty significantly predicts postoperative risks after cholecystectomy
A systematic review of nine cohort studies involving 128,421 participants found that frailty is a strong predictor of postoperative outcomes following cholecystectomy. The analysis revealed frail patients have a 5.54 times increased risk of short-term mortality and a 2.65 times higher risk of postoperative morbidity compared to non-frail individuals. Incorporating frailty assessments into preoperative evaluations […]
Whole blood resuscitation reduces trauma mortality rates significantly.
Whole blood (wb) resuscitation shows significant benefits in trauma patients, leading to lower odds of mortality at 4-hour, 24-hour, and 30-day intervals compared to component-only transfusions. Data from 12,275 patients indicate that higher wb to total transfusion volume (wb:ttv) ratios further decrease mortality, with each 10% increase correlating to a 13% reduction in 4-hour mortality […]
Early surgeon consultation increases cholecystectomy success rates.
In a study of 376 patients with symptomatic cholelithiasis, early surgical consultation significantly improved treatment outcomes. Only 23.7% received successful management, while 76.3% experienced failure. The success rate rose to 67.4% among those who received surgery consultations during hospital admission. Conversely, only 28.5% had outpatient consulting within 30 days post-visit. Factors such as age, sex, […]