Outpatient management of uncomplicated left-sided diverticulitis significantly reduces length of stay without increasing readmissions. Length of stay in the outpatient group was 29.7 hours shorter than inpatient care (p < 0.001). Co-morbid patients (ASA 3 and 4) faced a stay increase of 17 hours (53 hours vs. 35 hours, p < 0.001). Consider implementing an […]
Category: Appendix, Gallbladder and Surgical Emergencies
New Insights on Appendicitis Treatment Options
Endoscopic retrograde appendicitis therapy (ERAT) could reduce complications in select patients with uncomplicated appendicitis. ERAT has a complication rate of only 6.3%, significantly lower than antibiotics at 37.8%. Appendectomy remains the best for preventing recurrence (recurrence rate 0.6% vs. 53.2% for ERAT and 2.2% for antibiotics). ERAT might be a safe alternative for specific patients […]
Early ERCP cuts mortality in acute cholangitis from CBD stones.
Urgent ERCP (within 24 hours) significantly reduced in-hospital mortality to 0.5% compared to 21% for non-urgent (adjusted OR 0.09; p=0.024). Median hospital stay was shorter with urgent ERCP (5 days vs 8 days; p<0.001). Surgeons should prioritize early ERCP for moderate to severe cases to improve outcomes. Mortality benefits were pronounced in moderate and severe […]
Older Adults at Higher Risk Post-Hollow Viscus Injury
Older adults (65+) decompensate rapidly after blunt hollow viscus injuries, affecting surgical outcomes. Mortality odds for older adults undergoing surgery are eight times higher than for younger adults. Older adults wait nearly double the time to surgery compared to younger patients. Delays over one hour from admission to surgery significantly increase mortality risk. After 48 […]
New approaches in acute pancreatitis management
Early intervention and minimally invasive techniques are changing outcomes for acute pancreatitis. Early endoscopic retrograde cholangiopancreatography (ERCP) with sphincterotomy is critical for gallstone pancreatitis with cholangitis, followed by laparoscopic cholecystectomy. Interventional radiology enhances outcomes through percutaneous drainage and angiographic embolization for severe cases, reducing morbidity and hospital stay. Collaboration between surgery, gastroenterology, and interventional radiology […]
Intracholecystic ICG offers faster biliary visualization
Intracholecystic indocyanine green (ICG) provides quicker and clearer views of biliary anatomy during laparoscopic cholecystectomy. Cystic duct visibility improved from 70% pre-dissection (IV-ICG) to 85% (IC-ICG), reaching 95% post-dissection. Common hepatic duct visibility was 85% (IV-ICG) versus 45% (IC-ICG). Surgeons can use IC-ICG immediately, bypassing the delay associated with IV-administered ICG. Minor bile leakage occurred […]
New Triage Model Enhances Mass Casualty Outcomes
A new principles-based two-pass triage system aims to improve decision-making and efficiency in military mass casualty scenarios. 93% of assessed cases relied on simplified categorization over formal triage, highlighting the need for operationally relevant systems. The two-pass model allows for quick identification of casualties needing urgent care, followed by sorting into urgency levels for evacuation […]
Single-Incision Laparoscopic Cholecystectomy Rivals Traditional Method
Single-incision laparoscopic cholecystectomy (SILC) shows promise as a safe alternative to conventional methods, improving recovery times and cosmetic outcomes. Hospital stays are shorter with SILC at 1.94 days, compared to 2.25 days for traditional cholecystectomy. Patients report significantly less pain (2.19 vs. 2.80) and better cosmetic results (2.41 vs. 3.54 on Vancouver scar scores). Surgeons […]
New scoring system for acute appendicitis guides surgery decisions
Surgeons can now use a scoring system to determine the need for emergency surgery in acute appendicitis patients. A score of 9 or above indicates a 91.9% likelihood of requiring an emergency appendectomy. Scores of 4 or below suggest that 77.6% of patients can be treated conservatively with antibiotics. This tool enhances decision-making, especially in […]
Fragmented Care Raises Risks for Trauma Patients
Trauma patients frequently face higher risks when readmitted to nonindex hospitals, impacting surgical outcomes. 11.9% of trauma patients had a 90-day readmission after initial hospitalization. 28% were sent to nonindex hospitals, where they faced 11% higher adjusted odds of mortality and 12% increased odds of major complications. Addressing fragmented care is crucial for improving patient […]