Study of 600 patients shows robotic cholecystectomy in UK training program has low bile duct injury, conversion to open surgery, and need for subtotal cholecystectomy. Majority female, discharged same day with low 30-day readmission rate. Key indications: biliary colic, cholecystitis, gallbladder polyps, pancreatitis. Median stay: 0 days. Findings support safe implementation of robotic cholecystectomy in […]
Category: Appendix, Gallbladder and Surgical Emergencies
Improved outcomes seen with upper gastrointestinal specialist surgeons in emergency surgeries
Emergency upper gastrointestinal surgeries show better 30-day and in-hospital mortality outcomes when performed by specialists. A systematic review and meta-analysis of 24 articles found a significant decrease in mortality rates when UGI specialists were involved. Surgeons are advised to consider early subspecialist team involvement for improved patient outcomes. Journal Article by Barbaro A, Bunjo Z […]
Grading Esophageal Perforations Improves Outcome Predictions
Severely graded esophageal perforations (grades I-IV) impact patient survival differently, with grades II-IV showing lower overall survival rates. Factors such as duration of injury >24 hours, presence of mediastinitis, and esophageal necrosis are associated with unfavorable outcomes. Grading severity based on diagnostic CT scans, endoscopic, radiological, and clinical findings helps guide treatment decisions and may […]
Omitting Drains Improves Outcomes After Peptic Ulcer Repair
Omitting intraabdominal drains post peptic ulcer repair led to earlier recovery milestones, reduced pain severity, and shorter hospital stay. The no-drain group exhibited faster bowel function return, fluid and solid diet intake, along with decreased morbidity rates such as surgical site infections and respiratory complications compared to the drain group. These findings suggest that skipping […]
Previous Abdominal Surgery Increases Difficulty and Risks in Laparoscopic Cholecystectomy
Study finds that patients with previous abdominal surgery undergoing laparoscopic cholecystectomy and bile duct exploration had higher rates of adhesiolysis, difficult pedicles, and longer operative times. Specific surgeries like upper gastrointestinal and biliary procedures had the most significant risks. Modified access techniques were vital in mitigating complications for these patients. Previous open surgeries resulted in […]
Enhanced Recovery Program Reduces Hospital Stay in Trauma Patients
Implementing enhanced recovery principles in emergency laparotomy for penetrating abdominal trauma led to a 39% decrease in length of hospital stay (LOS) with no increase in postoperative complications. Opioid consumption was significantly lower, and patients on the program had earlier resumption of oral intake and removal of tubes and drains. These results indicate that enhanced […]
Appendicoscopy as a novel alternative for acute obstructive appendicitis
Appendicoscopy using a single-operator cholangioscope demonstrated a technical success rate of 96.4% and a clinical success rate of 91.8% in managing acute obstructive appendicitis. The procedure was effective, with 99.1% of patients experiencing pain relief within 6 hours and an average postoperative hospital stay of 3.5 days. No adverse events were reported, suggesting it is […]
NESTS Pathway Enhances Recovery for Spanish-Speaking Trauma Survivors
Spanish-speaking trauma and burn patients face unique challenges post-discharge, including mental health and socioeconomic needs. The NESTS pathway successfully identified and addressed these needs, connecting patients with community resources and improving access to mental healthcare. Food support was a prevalent need, with more patients connected to mental health resources than initially reported. This initiative highlights […]
Robotic Surgery in Emergency General Surgery in the US
Robotic emergency general surgery in the US increased significantly, with lower blood transfusion rates in large bowel resections and cholecystectomies. Costs were higher but postoperative complications were reduced, suggesting safety and efficacy. Robotic techniques are a valuable adjunct to laparoscopy, offering potential benefits in selected emergency operations. Increased adoption may be due to improved outcomes, […]
Shock Index Predicts Outcomes in Major Abdominal Emergency Surgery Patients
Shock index (SI) is a valuable tool for predicting postoperative mortality, acute kidney injury (AKI), ICU admission, and ICU length of stay in major abdominal emergency surgery patients. Significant associations were found between SI and mortality at 1 month, 3 months, and 2 years. Multivariate analysis confirmed the relationship between SI and 1-month and 3-month […]