The study explores terminology, classification, and significance of dysplasia and early carcinoma in the gallbladder and bile ducts. Most precursor lesions and early cancerous changes are clinically undetectable. Low-grade dysplasia is challenging to define and lacks clinical significance, but additional sampling is required to exclude significant lesions. High-grade dysplasia (carcinoma in situ) necessitates complete sampling […]
Category: Appendix, Gallbladder and Surgical Emergencies
Prophylactic mesh augmentation reduces incisional hernia incidence in emergency laparotomy closure
Prophylactic mesh augmentation in emergency laparotomy closure was evaluated through a meta-analysis of randomized controlled trials. After reviewing 33 studies, four were included in the analysis, involving 464 patients. The results showed a significant decrease in incisional hernia incidence when mesh reinforcement was used (OR 0.18; 95% CI 0.07-0.44; p
Predictors of Spontaneous Passage of Ingested Foreign Bodies in Adults
The study aimed to identify predictors for spontaneous passage of foreign bodies in adults by analyzing their characteristics, such as type, length, and location. A retrospective 12-year study included 365 patients, and the overall rate of spontaneous passage was 53.7%. Food impaction had a passage rate of 47.9%, sharp objects 44.3%, blunt objects 88.7%, and […]
The laparoscopic transabdominal preperitoneal technique is a safe and effective option for emergency inguinal and femoral hernia repair
A retrospective study compared the laparoscopic transabdominal preperitoneal (TAPP) technique with the open technique for emergency groin hernia repair. The TAPP group had younger patients with less severe clinical scenarios, while the open group had a higher incidence of bowel herniation and required more bowel resections. The TAPP group had shorter hospital stays and fewer […]
Subtotal Cholecystectomy—A Safe Alternative for Difficult Gallbladders
The study analyzed 1892 cholecystectomies, including 147 bailout procedures. They found that difficult anatomy and dense adhesions were the main reasons for bailout. Out of the bailout procedures, 63.4% were converted to open surgery, with 66% resulting in complete cholecystectomy. The study revealed that subtotal cholecystectomy is a safe alternative to total cholecystectomy for challenging […]
Prophylactic mesh augmentation reduces incisional hernia incidence in emergency laparotomy closure
Prophylactic mesh augmentation in emergency laparotomy closure was evaluated through a meta-analysis of randomized controlled trials. After reviewing 33 studies, four were included in the analysis, involving 464 patients. The results showed a significant decrease in incisional hernia incidence when mesh reinforcement was used (OR 0.18; 95% CI 0.07-0.44; p
Outpatient Laparoendoscopy for Cholecystocholedocholithiasis: Safe and Cost-effective Option
The study evaluated the safety and cost of outpatient laparoendoscopy for treating cholecystocholedocholithiasis. Data from patients treated between January 2015 and January 2019 were collected, and two groups were compared. The study found that outpatient treatment by laparoendoscopy was safe and viable for most cases, with lower costs. It also supports the reorientation of training […]
Accessory Appendicular Artery is Absent in Majority of Cases
The systematic review of 604 cases revealed that the accessory appendicular artery (AAA) is absent in most cases (83.6%). When present, it commonly originates from the posterior cecal artery (12.4%), followed by the descending branch of the ileocolic artery (2%), and the ileal branch of the ileocolic artery (0.7%). Instances of origin from the anterior […]
Body Mass Index Does Not Predict Injury Pattern or Outcome After Motorcycle Crash
The study aimed to compare the injury severity, mortality, injury regions, and length of hospital and intensive care unit stay between obese and normal-weight motorcycle crash patients. The analysis of trauma registries from three Pennsylvania level 1 trauma centers on 1,164 adult motorcycle crash patients showed no significant difference in injury severity, mortality, or injury […]
Which Antibiotic Regimen Fails in Nonoperative Treatment of Diverticulitis and Appendicitis?
Empiric antibiotic treatment of appendicitis is more likely to be associated with the need for additional antibiotics or procedure within 90 days compared to diverticulitis. Cephalosporin + metronidazole (c + m) was the most commonly used antibiotic regimen for appendicitis, while quinolone + metronidazole was more commonly used for diverticulitis. Treatment with c + m […]