A systematic review and meta-analysis of real-world studies examined the safety of direct oral anticoagulants (DOACs) in patients with non-valvular atrial fibrillation who experience gastrointestinal hemorrhage (GIH). Apixaban showed a lower risk of GIH compared to dabigatran, rivaroxaban, and vitamin K antagonists (VKA). Rivaroxaban was associated with an increased risk of GIH compared to dabigatran […]
Category: Appendix, Gallbladder and Surgical Emergencies
Tumor Necrosis Independently Predicts Poor Survival in Gallbladder Carcinoma Patients
This study delved into the significance of tumor necrosis in gallbladder carcinoma patients who underwent curative-intent surgery. Researchers analyzed 213 patients and found that the presence of tumor necrosis was linked to more aggressive tumor characteristics, such as larger size, poor differentiation, vascular invasion, lymph node metastasis, and higher tumor status. Importantly, tumor necrosis emerged […]
Objective Assessment of Laparoscopic Cholecystectomy Safety Proven Highly Reliable
A new, procedure-specific assessment called the Laparoscopic Cholecystectomy Critical View of Safety (LC-CVS OPSA) was developed to evaluate laparoscopic cholecystectomy performance. In a multinational study, this assessment exhibited high inter-rater reliability when used by expert laparoscopic cholecystectomy surgeons. The LC-CVS OPSA consists of six items focusing on safe surgical practices, offering a valuable tool for […]
Low Adherence to Guidelines in Acute Appendicitis Surgery Reveals Impact on Outcomes
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 […]
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 […]