Standardized electronic order sets significantly decreased inpatient opioid use for emergency general surgery patients from January 2019 to June 2023. The total morphine milligram equivalents (mme) per patient and average mme per opioid dose decreased notably, demonstrating sustained effects across administration routes. Additionally, lower mme medications were increasingly ordered, and multimodal regimens expanded, all while […]
Category: Appendix, Gallbladder and Surgical Emergencies
Cholecystectomy effectively resolves symptoms in biliary dyskinesia patients
A study of 415 patients identified that 89 (21%) had biliary dyskinesia, primarily affecting younger women (median age 46, BMI 28). Abdominal pain was the most common symptom. Pathological evaluations showed chronic cholecystitis in 84% of cases. Importantly, all patients with biliary dyskinesia experienced symptom resolution after cholecystectomy, suggesting this procedure is a first-line treatment […]
Robotic cholecystectomy shows better outcomes than laparoscopic method
A multihospital study analyzed 4,316 cholecystectomy patients, comparing robotic and laparoscopic techniques. Results indicated that robotic cholecystectomy was linked to significantly lower conversion rates to open surgery and overall favorable clinical outcomes. This research represents one of the largest retrospective analyses highlighting the benefits of robotic assistance in gallbladder surgery. The findings suggest a shift […]
ACS model enhances trauma care and surgeon satisfaction in Taiwan
The implementation of the acute care surgery (ACS) model at Chang Gung Memorial Hospital has revolutionized trauma care in Taiwan. This comprehensive approach, covering all stages from admission to discharge, has significantly improved patient outcomes. By broadening the role of trauma surgeons, the model not only ensures high-quality care but also fosters professional satisfaction among […]
High appendiceal tumor rate linked to periappendicular abscess
The research highlights a significant appendiceal tumor prevalence of 14.3% among patients with periappendicular abscess, markedly higher compared to 1.5% in those with uncomplicated appendicitis. Notably, age is a key risk factor, with patients over 35 years exhibiting increased tumor rates. The study proposes routine interval appendectomy for this demographic, emphasizing improved outcomes in terms […]
Sarcopenia and frailty predict poor outcomes after emergency surgery
A study involving 101 patients over 55 years undergoing emergency laparotomy revealed that sarcopenia, myosteatosis, and frailty are critical in predicting adverse outcomes. Notably, low grip strength and positive sarc-f questionnaire scores significantly associated with increased rehabilitation admission risk and likelihood of not returning home. Frailty was linked to fewer days alive outside the hospital […]
EUS-guided drainage proves effective for complicated diverticulitis
EUS-guided pelvic abscess drainage (EUS-PAD) using lumen-apposing metal stents demonstrates high efficacy and safety in managing complicated acute diverticulitis. In a study involving 53 patients, the procedure achieved a technical success rate of 92.5% and a clinical success rate of 88.7%. Adverse events were minimal, occurring in 3.8% of cases, with no procedure-related mortalities. EUS-PAD […]
Women and racial minorities face higher mortality in necrotizing fasciitis
Analysis of nearly 119,000 necrotizing fasciitis patients revealed women and certain racial minorities faced significantly higher in-hospital mortality than white counterparts. Women were 18% more likely to die, while Asian and Hispanic patients also showed increased mortality risks. Additionally, these groups experienced longer hospital stays and substantially higher costs, with Asian patients averaging $17,596 more […]
Whole-body CT becomes vital for diagnosing severe injuries.
A systematic review identified imaging strategies for patients with multiple or severe injuries, highlighting the importance of whole-body computed tomography (WBCT). Among 21 studies involving over 55,000 patients, extended focused assessment with sonography for trauma was recommended alongside WBCT as essential diagnostic tools. Modifications were made to existing recommendations, achieving strong consensus among experts regarding […]
TOS-1A thermobaric weapons inflict severe traumatic injuries
The study investigates the specific trauma caused by the TOS-1A thermobaric artillery during the Ukraine conflict. It found that injuries predominantly consisted of third- and fourth-degree burns, alongside significant respiratory damage and barotrauma. These injuries were more severe than those from conventional thermal sources. Findings underscore the urgent need for effective prevention strategies and specialized […]