This study delves into the challenges of applying international clinical practice guidelines (CPG) for acute appendicitis (AA). Researchers found that adherence to CPG is alarmingly low, particularly concerning peritoneal irrigation, abdominal drains, and antibiotic stewardship. Non-compliance, especially in complicated cases and technically challenging laparoscopic surgeries, leads to increased complications and higher costs. The study emphasizes […]
Category: Appendix, Gallbladder and Surgical Emergencies
Successful Laparoscopic Management of Iatrogenic Colon Perforation: A Promising Approach
Iatrogenic colon perforation, a rare but serious complication of colonoscopy, was studied to determine effective treatment approaches. Out of 51 cases, 84% required surgery. Notably, laparoscopic surgery was performed in 88% of cases, demonstrating its safety and feasibility. Laparoscopic primary suturing was successful in 80% of cases, with a high recovery rate of 96%. The […]
EUS-Guided Gallbladder Drainage Safer Than Percutaneous Cholecystostomy in High-Risk Patients
In high-risk surgical patients with acute cholecystitis, a systematic review and meta-analysis compared two alternative treatments: endoscopic ultrasound-guided gallbladder drainage using lumen-apposing metal stents (EUS-GBD-LAMS) and percutaneous cholecystostomy (PTGBD). The study found that while the two groups had similar early adverse events, EUS-GBD-LAMS was associated with significantly lower rates of delayed and overall adverse events. […]
Gunshot Wounds Pack a Bigger Punch Than Other Penetrating Trauma
This study delves into the impact of gunshot wounds (GSW) compared to other penetrating traumas. Researchers found that GSWs are far deadlier and complex, with higher odds of mortality compared to stab wounds. They lead to longer hospital stays, increased risk of complications like kidney injury and sepsis, and more ventilator days. Traditional injury scoring […]
Social Determinants of Health Impact Acute Care Surgery Outcomes
This study investigated the influence of social determinants of health on the outcomes of patients needing emergency general surgery or trauma care. The research used patient data from 2017 to 2020 in California and looked at the impact of social determinants of health codes related to socioeconomic and psychosocial factors. The findings showed that patients […]
Operative Management of Emergency General Surgery Conditions Incurs Higher Long-term Costs
Research found that for emergency general surgery (EGS) conditions, operative management resulted in higher in-hospital costs compared to non-operative approaches. However, over the long term, only patients with hepatopancreaticobiliary conditions experienced cost equivalence between operative and non-operative management at 90 and 180 days. For other EGS conditions, operative management maintained higher inpatient costs that slightly […]
Quality of Care in Appendicitis: Regional Hospitals Outperform Tertiary Care Centers
A comparative study of 2,158 adult appendicitis patients in different hospital settings revealed notable differences in surgical outcomes. Patients in tertiary care hospitals experienced longer surgical waiting times, increased surgical delays, longer operation times, higher rates of appendix perforation, and greater hospital costs compared to those in regional hospitals. Factors linked to surgical delays were […]
Embolization Reduces Failure of Nonoperative Management in Blunt Splenic Trauma
Researchers compared outcomes in patients with splenic pseudoaneurysms (PSAs) following blunt trauma, some treated with splenic artery embolization (Embo) and others without (No-Embo). Patients who underwent embolization had a significantly lower rate of failure of nonoperative management (FNOM) compared to the No-Embo group (3.1% vs. 13.3%). The study suggests that embolization may play a crucial […]
Prescribing Guideline Cuts Postoperative Opioid Use in Emergency Surgery
In emergency general surgery (EGS), there’s often no standardized approach to prescribing opioids for postoperative pain, raising concerns about overprescription. To address this, researchers introduced an opioid prescribing guideline. After implementation, they observed a significant reduction in prescribed opioid dosages at discharge. The proportion of patients receiving high-dose opioid prescriptions (≥50 morphine milligram equivalents per […]
Gender Disparity in Penetrating Trauma Outcomes: Insights from a Single-Center Study
While penetrating trauma occurs less often in females, a study delving into this specific demographic reveals some intriguing findings. Females, on average, had less severe injuries than males, but the mortality rates were similar. Surprisingly, females underwent fewer surgical or interventional radiology interventions. After accounting for age and injury severity, the study found no significant […]