Robotic cholecystectomy demonstrates safety and efficacy across various gallbladder pathologies in high-comorbidity patients, both elective and emergent. An analysis of 218 cases at a tertiary care facility from June 2020 to October 2023 revealed a 30-day complication rate of just 7.3%, with no bile duct injuries reported. Postoperative issues were primarily related to sickle cell […]
Category: Appendix, Gallbladder and Surgical Emergencies
Indocyanine Green Enhances Safety in Complex Liver Surgery
Anatomical segmentectomy of the liver using indocyanine green (ICG) fluorescence imaging significantly improves outcomes in cases of iatrogenic bile duct injury and recurrent cholangitis. A 46-year-old patient underwent surgical resection with ICG aiding in precise tissue identification and visualization, resulting in a successful procedure without bile leaks. Enhanced imaging of atrophic regions and abnormal biliary […]
Machine Learning Nomogram Predicts Laparoscopic Surgery Difficulty
A novel machine learning-based nomogram accurately predicts the surgical difficulty of laparoscopic cholecystectomy in gallstone patients. By analyzing 362 cases, the model integrated critical clinical and inflammatory indicators, achieving an impressive AUC of 0.863 in the validation set. This predictive capability enhances surgical planning and optimizes patient outcomes, encouraging a shift toward data-driven decision-making in […]
Male Sex and Acute Cholecystitis Raise Bile Duct Injury Risk
Male sex and acute cholecystitis significantly elevate the risk of bile duct injury during cholecystectomy, with adjusted odds ratios of 1.27 and 1.74, respectively. The meta-analysis, examining over 6.5 million surgeries, also found inconsistent documentation of the critical view of safety, which lacked a statistical link to reduced injury rates. Routine use of intraoperative cholangiograms […]
Acute Pancreatitis Hospitalizations Decline Amid COVID-19 in Japan
In 2021, Japan saw a significant drop in acute pancreatitis (AP) hospitalizations, declining to 61,080 cases from 78,450 in 2016, marking a 49 per 100,000 incidence rate. The mortality rate among severe cases improved to 5.3%, down from 6.1%. Treatment adherence improved; 61.2% of patients received antibiotics and 56.9% of severe cases benefited from enteral […]
Reduced reliance on percutaneous cholecystostomy improves outcomes
A quality improvement initiative across eight teaching hospitals significantly reduced percutaneous cholecystostomy usage for acute calculous cholecystitis, dropping from 9.7% to 7.2%. Post-implementation data indicated a decrease in 30-day mortality (odds ratio 0.60) and increased laparoscopic cholecystectomy rates (94.5% to 96.3%). Although minor bile duct leaks rose from 0.9% to 2.1%, no major duct injuries […]
Preemptive analgesia reduces postoperative pain after laparoscopic cholecystectomy
In a comparison of pain management techniques, intercostal nerve block combined with incisional infiltration anesthesia significantly alleviated postoperative pain in laparoscopic cholecystectomy patients. The intervention group reported lower pain scores at all measured intervals, evidencing less reliance on additional tramadol. Furthermore, patients in the intervention group experienced shorter hospital stays and quicker ambulation without compromising […]
Appendicitis-related mortality trends reveal concerning gender disparities
From 1999 to 2020, appendicitis-related mortality decreased overall but revealed significant disparities. The age-adjusted mortality rate fell from 0.38 to 0.32 per 100,000, with a notable decline for males but a concerning rise for females since 2016. Black individuals had the highest mortality rates, although significant declines were observed across racial groups. Nonmetropolitan regions experienced […]
Trauma center care improves outcomes for injured patients
Analysis of statewide discharge data shows that trauma centers significantly reduce risk-adjusted mortality rates and complications, such as acute kidney injury and pulmonary embolism, compared to non-trauma facilities. However, they report higher rates of ventilator-associated pneumonia and surgical site infections. Notably, while trauma centers predominantly treat pediatric patients and those with severe injuries, geriatric patients […]
Shorter antibiotic courses prove effective for complicated appendicitis
A systematic review of 11 studies involving 8,361 participants demonstrates that shorter intravenous antibiotic courses (2-6 days) are non-inferior to longer regimens for preventing infections after complicated appendicitis. Early transitions to oral antibiotics also show effectiveness, reducing hospital stays and healthcare costs. Key risk factors affecting antibiotic duration include disease severity and surgical complexity. The […]