Cholecystectomy for uncomplicated cholelithiasis in sickle cell disease (SCD) patients leads to lower postoperative vaso-occlusive crises compared to those with acute cholecystitis, chronic cholecystitis, or gallstone pancreatitis. Advanced clinical presentations are strong predictors of complications, with 73% of SCD patients showing advanced clinical presentation at the time of cholecystectomy. These findings suggest that early cholecystectomy […]
Category: Appendix, Gallbladder and Surgical Emergencies
Continuous Preventable Mortality Review: Driving Reduction in Trauma Mortality
By using continuous preventable mortality review to guide provider education, the Arkansas Trauma System saw a progressive reduction in preventable or potentially preventable deaths from 2015 to 2022. A total of 1,979 trauma deaths were analyzed, with a 43% decrease in preventable or potentially preventable deaths. Education focusing on improving trauma care, particularly in reducing […]
High Mortality Rates in Hypotensive Combat Casualties Requiring Emergent Laparotomy
Combat casualties requiring emergent laparotomy have a mortality rate of 29.5%, compared to 6.5% in normotensive patients. Despite implementing damage control principles, mortality rates remained high in hypotensive patients. The study analyzed 1051 patients, showing no improvement in hypotensive casualty mortality rates after the implementation of clinical practice guidelines. Journal Article by Pumiglia L, Williams […]
Successful Surgical Management of Sigmoid Gallstone Ileus Resulting in Patient Discharge
Researchers report a successful case of a 90-year-old woman with a 6 cm gallstone causing sigmoid colon obstruction. Despite deferring colonoscopy due to gallstone size, urgent laparotomy for gallstone removal resulted in uneventful post-operative recovery and discharge on the 6th day. The study highlights the importance of multidisciplinary discussions between endoscopists and surgeons for optimal […]
The Lethal Triad: Acute Cholecystitis, Obesity, and Steatohepatitis Increase Bile Duct Injury Risk
The study analyzed 387,501 laparoscopic cholecystectomy cases from the NSQIP registry and found that the presence of the lethal triad (acute cholecystitis, obesity, and steatohepatitis) significantly increased the risk of bile duct injury (BDI) by over 15-fold. Those with the triad had a BDI incidence rate of 1.49% compared to 0.09% in those without. This […]
Small Bowel Obstruction Recurrence Score (SBORS) Predicts Risk of Recurrence in Patients with History of Intra-abdominal Surgery.
Researchers conducted a study in Taiwan to assess the risk of recurrent small bowel obstruction (SBO) after non-operative management in patients with a history of intra-abdominal surgery. They developed a scoring system, the Small Bowel Obstruction Recurrence Score (SBORS), which successfully predicted 6-month recurrence of SBO after non-surgical management. Patients with scores >2 had higher […]
Endoscopic Vacuum Therapy Shortens Treatment Duration for Esophageal Perforations
Patients with traumatic esophageal perforations treated with endoscopic vacuum therapy (evt) had significantly shorter treatment duration than those treated with endoscopic self-expandable metal stent (e-sems). However, e-sems led to a shorter time of hospitalization and lower costs. Both methods had similar clinical outcomes, with high discharge rates. Journal Article by de Oliveira AT, Barreira MA […]
Improving Trauma Care Access and Equity in South Side Chicago
The study discusses the opening of a trauma center at University of Chicago Medicine and its impact on the south side of Chicago. Since its establishment in 2018, the trauma center has become one of the busiest in the country with a high penetrating trauma rate. Patient transport time on the south side has significantly […]
Can Endoscopic Gallbladder Stenting Prevent Recurrent Cholecystitis in Deferred Cholecystectomy?
Endoscopic gallbladder stenting significantly reduced the rate of recurrent cholecystitis at 3 months compared to patients who did not receive stenting. At 3-6 months, the stenting group also showed a lower, though not statistically significant, rate of recurring cholecystitis. The majority of recurrences in the non-stenting group occurred within 3 months, indicating that endoscopic stenting […]
Operative Management of Emergency General Surgery Conditions: Higher Costs Which Persist Over Time
Operative management of emergency general surgery conditions leads to higher in-hospital costs compared to nonoperative management, with costs remaining higher or equivalent through 180 days. Out-of-pocket costs are similar for both approaches. For hepatopancreaticobiliary conditions, costs for operative management start higher but become equivalent at 90 and 180 days. These findings have implications for decision-making […]