The C-GALL trial compared conservative management with laparoscopic cholecystectomy in adults with uncomplicated symptomatic gallstone disease. After 18 months, there was no significant difference in quality of life between the two groups. Furthermore, conservative management was found to be less costly and there was no significant difference in quality-adjusted life years. The study suggests that […]
Category: Appendix, Gallbladder and Surgical Emergencies
Incidentally detected T2 gallbladder cancer associated with poorer outcomes compared to upfront surgery
Incidentally detected T2 gallbladder cancer (pt2 GBC) has been found to have significantly worse outcomes compared to similarly staged patients who undergo upfront radical cholecystectomy. A retrospective analysis of 425 cases revealed that patients with incidentally detected tumors had higher rates of locoregional, liver, and abdominal wall recurrences. The five-year disease-free survival rate was lower […]
Comparison of outcomes between re-resected incidental gallbladder carcinoma and primary gallbladder carcinoma
Patients with re-resected incidental gallbladder carcinoma (rrigbc) had better prognosis and were at earlier tumor stage compared to those with primary radically resected gallbladder carcinoma (prgbc). Subgroup analysis revealed similar outcomes for patients with T1-2 tumors in both groups. However, patients with T3-4 tumors in the prgbc group had significantly worse prognosis. Incidental gallbladder carcinoma […]
Laparoscopic Cholecystectomy Effectively Alleviates Symptoms in Patients with Normal Ejection Fraction
Laparoscopic cholecystectomy is found to be effective in improving symptoms for patients with abdominal pain and biliary dyskinesia (low ejection fraction 35%). In a retrospective study of 117 patients with negative workup, including normal ejection fraction, who underwent laparoscopic cholecystectomy, 84% reported resolution of pre-operative symptoms. There was no significant correlation between pain during hida […]
Subtotal Cholecystectomy: Safe Approach with Postoperative ERCP for Bile Leak Resolution
This study examined 102 cases of subtotal cholecystectomy (STC) as a strategy for difficult cholecystectomies. Of all patients with STC, 47.1% underwent intra- or postoperative ERCP. Bile leak was the main indication for ERCP, with a higher resolution rate for postoperative ERCP (95.7%) compared to intraoperative ERCP (60.0%). No injuries to the central bile ducts […]
Optimal Surgical Management and Outcomes of Abdominal Catastrophes Secondary to Intestinal Lymphomas
A systematic review was conducted to assess the presentation, diagnosis, optimal surgical approach, and post-operative outcomes of abdominal catastrophes secondary to intestinal lymphomas. A total of 95 patients were identified, with Burkitt’s lymphoma and diffuse large B-cell lymphoma being the most common types. Small bowel resections had a 25% complication rate and a 13.8% 30-day […]
Outpatient appendectomy for uncomplicated acute appendicitis: Safe, effective, and cost-saving
The PENDI-CSI Randomized Clinical Trial assessed the safety, efficacy, and cost-effectiveness of outpatient appendectomy for uncomplicated acute appendicitis. With 85.9% of patients discharged without admission, the study found that outpatient surgery is safe and effective. Predictors for admission included age over 31 years, hypertension, high anesthetic risk, previous abdominal surgery, postoperative pain, and fear. There […]
Delaying surgery until the morning shown to be non-inferior for acute appendicitis patients presenting at night
Delaying appendectomy until the following morning is non-inferior to immediate surgery in adults with acute appendicitis presenting at night, according to a randomized controlled trial. The study found that delaying surgery did not increase the risk of postoperative complications, meeting the noninferiority criteria. However, the mean time between the decision to operate and surgery was […]
Long-Term Results of Conservative Management for Complicated Colonic Diverticulitis: Effective and Safe Option for Selected Patients
The study investigated the long-term outcomes of conservative management for complicated colonic diverticulitis. The results showed that non-operative treatment is effective and safe for selected patients, with recurrence rates of 38.1% and high severity recurrence rates of 11.1%. Lower CT stages and grade III diverticulitis were associated with higher recurrence rates. Chronic NSAID use was […]
High incidence of bile duct injuries during laparoscopic cholecystectomies highlights need for improved techniques
The 11-year population-based study on bile duct injuries (BDIs) during laparoscopic cholecystectomies (LC) revealed an overall BDI incidence rate of 0.81%, with minor and major BDI rates of 0.68% and 0.13%, respectively. No significant decline in BDI incidence was observed over the study period, contradicting the hypothesis. Drainage and ERCP stent placement were the most […]