In a comprehensive meta-analysis of 701 patients, endoscopic ultrasound-guided gallbladder drainage (EUS-GBD) achieved an impressive 95.8% technical and clinical success rate for treating acute cholecystitis with over one year of follow-up. This method stands out as a safe and durable alternative, especially for high-risk surgical patients, showcasing a remarkably low rate of adverse events. The […]
Category: Appendix, Gallbladder and Surgical Emergencies
Robotic surgery shows better outcomes in emergency colorectal cases
Analyzing over 83,000 emergency colorectal surgeries, researchers found that robotic procedures cut complications, reduced hospital stays, and slashed conversion rates compared to laparoscopic and open surgery. Robotic cases had a 7.8% conversion to open surgery vs. 24.2% in laparoscopy. Length of stay was significantly shorter, and complications fewer. Robotic use jumped from 0% to 6.6% […]
Balanced transfusion strategies show promise in hemorrhage management.
Advancements in massive transfusion protocols (MTPs) highlight the importance of balanced transfusion strategies, utilizing a 1:1:1 ratio of plasma, platelets, and red blood cells. This approach significantly enhances early hemorrhage control, though challenges persist with individual patient variability. Viscoelastic hemostatic assays facilitate personalized treatment by providing real-time clot assessments. Renewed interest in whole blood transfusions, […]
Essential Variables for Trauma Registries in Low-Middle-Income Countries Identified
A Delphi survey revealed 37 essential variables for adult trauma registries in low-middle-income countries, with demographic data, injury details, and clinical assessments leading the list. Following a two-round expert consensus process, additional optional variables emerged, including education and income levels. Birthplace was excluded. These insights aim to enhance trauma care in resource-constrained settings, emphasizing the […]
Endovascular management improves outcomes in acute mesenteric ischaemia
A scoping review of 39 studies on acute mesenteric ischaemia indicated that endovascular interventions significantly improved patient outcomes. Notably, they showed lower 30-day mortality rates compared to open surgery, ranging from 0% to 53.8% versus 21% to 81%. Additionally, patients receiving endovascular treatment experienced shorter hospital and ICU stays. However, delays in diagnosis, averaging between […]
Radiomics-clinical model enhances prediction of difficult laparoscopic cholecystectomy
A novel predictive model combining preoperative CT radiomics and clinical data effectively identifies patients at risk for difficult laparoscopic cholecystectomy (DLC). An analysis of 2,055 cases revealed a top-performing model using random forest algorithms, achieving an AUC of 0.938 in the training cohort and 0.874 in validation. The model incorporates ten key features, including gallbladder […]
Dexmedetomidine enhances postoperative pain relief after appendectomy
Combining dexmedetomidine with hyperbaric bupivacaine significantly delayed postoperative pain onset for patients undergoing appendectomy under spinal anesthesia, achieving mean times of 259.43 and 454.65 minutes for the two dexmedetomidine groups, compared to 154.04 minutes in the control group. The study maintained overall hemodynamic stability, although group 3 experienced lower heart rates and blood pressure, with […]
Gastrografin use shortens surgery time and hospital stay
Use of gastrografin for adhesive small bowel obstruction has significantly improved clinical outcomes. A study analyzed over 20,000 patients, revealing a reduction in time to the operating room, from an average of 2.63 days pre-gastrografin to 2.33 days post-gastrografin. Additionally, hospital length of stay decreased from 10.51 days to 6.09 days. Notably, the number of […]
Robotic approach reduces surgical challenges in obese patients.
Obese patients undergoing robotic cholecystectomy demonstrated significant improvements over laparoscopic procedures, with a conversion rate to open surgery of 0.0% compared to 3.2% in laparoscopic cases. Additionally, robotic-assisted patients experienced shorter hospital stays, averaging 1 day, versus 1 day for those undergoing laparoscopic cholecystectomy. The findings indicate that robotic cholecystectomy may provide superior postoperative outcomes […]
Suboptimal CT imaging leads to increased mortality in older trauma patients
A secondary analysis of 5,496 older blunt trauma patients revealed that 8.6% experienced suboptimal computed tomography (CT) imaging. Most missed injuries were identified in the thoracic and lumbar spine regions. Patients with suboptimal imaging had a significantly higher mortality rate and longer hospital stays. Factors contributing to these missed injuries included imaging conducted before transfer […]