In a review of 6,140 laparoscopic cholecystectomies and bile duct explorations, researchers found that abdominal drains were utilized in 52.5% of cases, particularly in older patients and emergency admissions. While drains contributed to early detection of bile leaks and monitoring post-operative conditions, complications remained rare. The study suggests that a selective approach to drain use […]
Category: Appendix, Gallbladder and Surgical Emergencies
Predictive models for mortality in polytrauma patients perform comparably
A study assessing the Parkland Trauma Index of Mortality (PTIM) model validated similar predictive performance in a new cohort of polytrauma patients. The results from approximately 5,000 trauma patients revealed impressive sensitivity (up to 82.5%) and specificity (97.3%). The overlap in clinical variables used in the PTIM and the new Cincinnati Trauma Index of Mortality […]
C-reactive protein and albumin ratio may aid cholecystitis diagnosis
An analysis of 170 patients with acute cholecystitis revealed that 37.1% had gallbladder perforation, correlated with higher rates of complications. Key biomarkers, including C-reactive protein (CRP) and the CRP/albumin ratio (CAR), demonstrated significant differences between perforated and non-perforated cases. Despite their low specificity and sensitivity, these biomarkers can assist clinicians in making timely diagnoses and […]
Endoscopic Vacuum Therapy effectively treats Boerhaave’s syndrome.
A multicenter analysis demonstrates that Endoscopic Vacuum Therapy (EVT) has a high success rate for treating Boerhaave’s syndrome, yielding an 80% treatment success in 25 patients. Mortality rates were significantly lower for EVT patients (8.0%) compared to those undergoing other methods (25.0%). Moreover, treatment success with EVT was statistically superior to non-EVT approaches (43.8%). These […]
New roadmap aids in identifying futile resuscitation in trauma patients
A systematic review highlights the urgent need for reliable parameters that indicate futile resuscitation among severely bleeding trauma patients. By examining existing literature, researchers propose a clear roadmap to guide clinicians in recognizing when massive transfusions may be ineffective. This approach aims to enhance blood product stewardship amid ongoing challenges in maintaining blood supply, ensuring […]
High neutrophil-lymphocyte ratio indicates increased mortality risk in UGIB patients
A study involving 726 patients with upper gastrointestinal bleeding (UGIB) revealed that a high neutrophil-lymphocyte ratio (NLR) on admission significantly predicts in-hospital mortality risk. Researchers found that while 6% of patients died, 23.9% required endoscopic intervention, and 46.4% needed blood transfusion. The integration of NLR with the Glasgow-Blatchford Score and Full Rockall Score enhanced risk […]
High-performing trauma centers demonstrate better quality adherence.
Analysis of over 1.4 million patients across 442 trauma centers reveals significant variations in risk-adjusted mortality. High-performing trauma centers (HPTC) exhibited lower complications and higher adherence rates to American College of Surgeons (ACS) quality measures, particularly in balanced resuscitation, pediatric admissions, and substance abuse screening. The findings underscore a clear correlation between adherence to quality […]
Machine learning models enhance triage for abdominal pain surgery
Machine learning models significantly outperform traditional logistic regression in predicting emergency surgery for abdominal pain patients. An analysis of 38,214 individuals identified 4,208 requiring emergency surgical intervention. Key results showed that the Light GBM model achieved an area under the curve (AUC) of 0.899, improving clinical decision-making through enhanced sensitivity and specificity. Overall, these advancements […]
Polymeric clips are more effective than endoloops in appendectomy
A systematic review and meta-analysis of 13 studies revealed polymeric clips significantly reduced surgical time compared to endoloops during laparoscopic appendectomy for uncomplicated appendicitis (standardized mean difference 0.37, p < .00001). No notable differences were observed in hospital stay or overall complications. However, the endoloop showed a higher incidence of intra-abdominal abscess (risk ratio 3.53, […]
Endoscopic therapy effectively diagnoses and treats acute appendicitis.
Direct visualization endoscopic retrograde appendicitis therapy effectively diagnosed acute uncomplicated appendicitis in 35 of 36 patients (97.2%). The mean procedure time was 13.1 minutes, with a low complication rate. One patient required a laparoscopic appendectomy after experiencing recurrent abdominal pain. The average length of hospital stay was 1.78 days, with a follow-up period of approximately […]