Endoscopic ultrasound-guided gallbladder drainage (EUS-GBD) is a safe and effective option for nonoperative candidates with symptomatic cholelithiasis without cholecystitis. Complete gallstone clearance achieved in 100% of patients; 87% cleared in one treatment. All 23 patients had technical success with LAMS placement, and no procedure-related adverse events occurred. No symptom recurrence noted over a mean follow-up […]
Category: Appendix, Gallbladder and Surgical Emergencies
Hem-o-lok Clips Outperform Endoloops for Appendiceal Closure
Hem-o-lok clips provide a safer and faster option for appendiceal stump closure in laparoscopic appendectomy compared to endoloops. Intra-abdominal abscess formation was 1.87 times less likely with hem-o-lok clips (p=0.035). Operative time was significantly shorter by an average of 5.41 minutes (p=0.019). Surgeons may consider hem-o-lok clips for improved outcomes and efficiency in appendectomies. No […]
Indocyanine Green Fluorescence Cuts Bile Duct Injury Risk in Cholecystectomy
Intraoperative indocyanine green (ICG) use significantly reduces common bile duct (CBD) injury rates during laparoscopic cholecystectomy. CBD injury decreased from 0.40% to 0.25% with ICG (RR 0.62; p < .001). Postoperative biliary interventions were lower with ICG (4.49% vs 5.39%; RR 0.83; p < .001). Conversion to open surgery also fell (0.84% vs 0.40%; RR […]
Learning curve impacts outcomes in gallstone surgery
Surgical outcomes and operation times improve significantly with experience in laparoscopic cholecystectomies. Mean operation time drops from 111 minutes to 75 minutes after 800 procedures. Complication rates are significantly lower with an assistant present, from 7.0% to 4.7% during the initial 50 procedures (p=0.007). Surgeons should prioritize mentorship and assistance during early cases to enhance […]
Intraoperative Cholangiography Use Doesn’t Lower Bile Duct Injury
Surgeons should know that increased use of intraoperative cholangiography (IOC) during cholecystectomy does not reduce bile duct injury rates, but it does lead to more postoperative ERCP procedures. Among 434,696 patients, BDI rates were low and similar across IOC use groups (0.5% for never, 0.4% for selective, and 0.4% for routine). Postoperative ERCP rates increased […]
Robotic Cholecystectomy Cuts Complications in Complex Cases
Robotic-assisted cholecystectomy significantly reduces the need for unplanned procedures in complex gallbladder surgeries. Patients undergoing robotic cholecystectomy had a 4.24 odds ratio for fewer interventions compared to laparoscopic techniques (p = .02). Operating room costs are higher for robotics: $8,936 vs. $7,720 for laparoscopic in complex cases. Robotic cholecystectomy maintains overall care costs similar to […]
Early Foley Catheter Removal Safe After Colovesical Fistula Surgery
Early removal of Foley catheters post-segmental colectomy for diverticulitis shows promise in reducing complications. 90.8% of patients had catheters removed by postoperative day 2 or 3. No cases of bladder leaks, catheter reinsertion, or colovesical fistula recurrence were reported. Consider adopting early Foley removal as a routine practice to minimize urinary tract infection risks in […]
Angioembolization Equals Survival to Surgery in Liver Trauma
Angioembolization offers equivalent survival rates compared to surgery for penetrating liver trauma but leads to longer hospital stays. Mortality rates were similar: 2.0% for angioembolization vs 4.8% for surgery (p = .069). Hospital stay averages: 17.3 days for angioembolization vs 11.7 days for surgery (p < .001). Identifying patients who are at higher risk for […]
Nature Sounds Cut Pain and Anxiety After Cholecystectomy
Listening to nature sounds during early mobilization post-laparoscopic cholecystectomy significantly reduces anxiety, pain, and stress levels. Patients exposed to nature sounds reported lower anxiety, pain, and stress scores compared to controls. The intervention group maintained significant reductions even when controlling for surgical history. Integrating this low-cost intervention into nursing care can enhance patient recovery. Journal […]
Robotic Cholecystectomy Shows Promising Outcomes Versus Open Surgery
Robotic cholecystectomy is gaining traction and appears to improve patient outcomes compared to open surgery. Robotic approach linked to 85% lower odds of bile duct injury (OR 0.15) and 74% lower odds of death (OR 0.26). Patients undergoing robotic cholecystectomy had a 3.4-day shorter postoperative stay but incurred $1,000 more in costs. Surgeons should consider […]