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, […]
Category: Appendix, Gallbladder and Surgical Emergencies
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 […]
Global survey reveals gaps in awareness of abdominal pressure guidelines
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 […]
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 […]