An urban prehospital whole blood (ph-wb) program effectively treated 375 trauma patients, administering 588 units of whole blood. Patients experienced significant improvements in systolic blood pressure, averaging a rise of 28 mmHg, while pulse decreased by 19 bpm before reaching the emergency department. Notably, 83% survived 24 hours and 80.8% were alive after 30 days. […]
Category: Appendix, Gallbladder and Surgical Emergencies
Laparoscopic Surgery Reduces Mortality and Complications for Peptic Ulcers
Laparoscopic treatment of perforated peptic ulcers significantly cuts mortality and postoperative complications compared to open surgery. A network meta-analysis of 16 studies with 1,259 patients revealed lower odds of death (OR 0.36) and fewer wound infections (OR 0.15) and ileus (OR 0.33) with laparoscopic methods. While alternative strategies lacked sufficient evidence, this analysis confirms laparoscopic […]
Robotic cholecystectomy eradicates conversions to open surgery in high-risk patients
After adopting robotic surgery for benign gallbladder disease, conversion rates to open surgery dropped dramatically to zero. In a study of 636 patients, conversion rates declined from 14.6% in the pre-robotic era to 4.0% during the transition and reached 0% in the robotic period. While post-operative complications and hospital readmissions remained consistent across eras, this […]
Quality of Life Surges for Survivors After Emergency Abdominal Surgery
Quality of life after emergency abdominal surgery improves significantly for survivors over time. Initial post-operative EQ-5D-3L utility scores averaged just 0.21, but soared to 0.74 within three to eight months. Key early determinants include patient’s sex and preoperative risk levels, while longer-term outcomes are influenced by hospital stay duration and overall health status. Insights can […]
Index Admission Cholecystectomy Cuts Mortality and Readmission Rates in Acute Cholangitis
Cholecystectomy during the initial hospital admission for acute cholangitis significantly reduces in-hospital mortality and lowers readmission rates at 30 and 90 days. Among over 29,000 patients studied, those receiving surgery on admission exhibited a 60% lower mortality risk and substantially improved readmission outcomes, regardless of severity. Findings urge a re-evaluation of surgical timing in management […]
Staged Resection for Appendiceal Cancer Doesn’t Compromise Survival
Staged right colectomy (SRC) for appendiceal cancer matches overall survival outcomes compared to upfront right colectomy (URC), with SRC reducing unnecessary surgeries. Analysis of 908 patients revealed that URC was often reserved for larger, higher-grade tumors. Adjusted results show SRC demonstrates equivalent survival in elective cases, emphasizing its role in avoiding overtreatment. This approach may […]
48-Hour Symptom Onset Marks Elevated Risk for Perforated Appendicitis
A clinical risk model underscores that a 48-hour symptom threshold significantly predicts perforation in acute appendicitis. An analysis of 414 patients revealed that longer delays before hospital presentation correlate with increased perforation risk. Notably, time intervals over 48 hours yielded an adjusted odds ratio of 3.30 for perforation. Elevated CRP levels and the presence of […]
Endovascular Management Cuts Mortality and Length of Stay in Acute Mesenteric Ischaemia
Acute Mesenteric Ischaemia (AMI) carries a staggering 50% mortality risk. A scoping review of 39 studies (20,991 patients) reveals endovascular interventions outperform open surgery, yielding lower 30-day mortality rates (0%-53.8% vs. 21%-81%) and shorter hospital (5-15.35 days vs. 5.7-27.26 days) and ICU stays (0-5.35 days vs. 2-13 days). Timely diagnosis and careful patient selection are […]
Early stoma reversal significantly reduces complications and hospital stay
Timing of stoma reversal plays a critical role in patient outcomes. In a retrospective cohort study of 505 patients, those reversed within 18 months experienced significantly lower complication rates (7.9% vs. 35.1%) and shorter hospital stays (6 days vs. 7 days). Alarmingly, 28.9% underwent reversal, highlighting a gap in post-operative care. Factors such as male […]
New AI Framework Standardizes Intraoperative Inflammation Severity in Cholecystectomy
A novel AI tool, ENDOLAP, accurately classifies inflammation severity during laparoscopic cholecystectomy, addressing the subjectivity of current assessments. With an impressive overall accuracy of 87.3% and high sensitivity for severe cases (91.3%), it offers real-time decision support and reduces interobserver variability, which plagued 17% of previous evaluations. The framework represents a significant leap towards standardized […]