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Identifying Low Phospholipid Associated Cholelithiasis as an Under-Recognized Cause of Post-Cholecystectomy Pain

Post author By STITCHES Newsletter
Post date 27/02/2024
Categories In Appendix, Gallbladder and Surgical Emergencies, General Surgery

Among patients under 40 undergoing cholecystectomy, 1.9% exhibited symptoms suggestive of low phospholipid associated cholelithiasis (lpac). Family and obstetric history may aid in its diagnosis, as none of the lpac cases were initially recognized by clinicians. This study highlights the importance of considering lpac in cases of post-cholecystectomy pain, as timely treatment can prevent long-term complications.

Journal Article by Trinh A, Tjandra D (…) Metz AJ et 6 al. in ANZ J Surg

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Endoscopic gallbladder stenting reduces recurrent cholecystitis in deferred cholecystectomy patients

Post author By STITCHES Newsletter
Post date 26/02/2024
Categories In Appendix, Gallbladder and Surgical Emergencies, General Surgery, Surgical Endoscopy

Endoscopic gallbladder stenting (ETGS) significantly reduces recurrent cholecystitis in patients with deferred cholecystectomy, demonstrating 0% recurrence at 3 months compared to 18.3% in the non-ETGS group. Although not statistically significant, ETGS also shows a trend towards lower recurrence (0% vs. 10%) at 3-6 months. Technical and clinical success rates for ETGS are 90% and 100%, respectively, highlighting its efficacy in preventing cholecystitis. Results suggest ETGS’s potential as an adjunctive treatment in acute cholecystitis with common bile duct stones.

Journal Article by Ridtitid W, Karuehardsuwan J (…) Rerknimitr R et 7 al. in Gastroenterology

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Declining Opioid Prescriptions, Yet Disparities Persist

Post author By STITCHES Newsletter
Post date 26/02/2024
Categories In General Surgery, Perspectives, Opinions and Curiosities

Surgeons in the US decreased opioid prescriptions post-surgery from 2013 to 2017, with 81.6% of counties showing a decreasing trend. Factors such as lower median population age, higher education levels, insufficient sleep rates, healthcare costs, fewer mental health providers, and uninsured adults were linked to higher opioid prescription rates. Suboptimal access to healthcare, particularly mental health services, may contribute to increased opioid prescribing after surgery.

Journal Article by Gaitanidis A, Dorken Gallastegi A (…) Kaafarani HM et 3 al. in J Am Coll Surg

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Mood and Sleep Improvement Post-Parathyroidectomy for Primary Hyperparathyroidism

Post author By STITCHES Newsletter
Post date 26/02/2024
Categories In Endocrine Surgery, General Surgery

Patients with primary hyperparathyroidism experience significant improvements in mood and sleep quality after parathyroidectomy. Depression scores significantly decreased at 3 and 12 months post-surgery compared to preoperative levels. Sleep quality showed improvement at 12 months, particularly in daytime dysfunction. These findings highlight the importance of considering mood and sleep disturbances in preoperative assessments for patients with primary hyperparathyroidism.

Journal Article by Febrero B, Ruiz-Manzanera JJ (…) Rodríguez JM et 2 al. in BMC Surg

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Biologic Therapies Effective in Chronic Antibiotic Refractory Pouchitis

Post author By STITCHES Newsletter
Post date 26/02/2024
Categories In General Surgery, Intestine and Lower Gastrointestinal Tract

Studies on chronic antibiotic refractory pouchitis highlight limited evidence for non-pharmacologic therapies while demonstrating efficacy of biologic therapies such as mesalamine, budesonide, anti-tumor necrosis factor alpha therapies, ustekinumab, and vedolizumab in managing the condition. Biologic therapies offer a steroid-sparing option, with vedolizumab showing favorable results in randomized controlled trials. Non-medication therapies like hyperbaric oxygen and fecal microbiota transplant require further research for accessibility.

Journal Article by Weber AT and Lichtenstein GR in Dis Colon Rectum

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Low Risk of Health Hazards from Surgical Smoke Generated by Electrocautery

Post author By STITCHES Newsletter
Post date 26/02/2024
Categories In General Surgery, Perspectives, Opinions and Curiosities

Exposure to surgical smoke from electrocautery in operating rooms poses minimal health risks to personnel, with low levels of pollutants and particulate matter. Virus transmission through electrocautery remains uncertain. Current mandates for smoke evacuators are deemed unnecessary based on the limited health hazards associated with surgical smoke exposure.

Review by Hurst RD and Stewart CL in Am J Surg

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Variable Complication Reporting in Canadian Trauma Registries

Post author By STITCHES Newsletter
Post date 26/02/2024
Categories In Appendix, Gallbladder and Surgical Emergencies, General Surgery

In a comparison of nine trauma registries in Canada, researchers found significant variability in the abstraction and definitions of complications reported. Of the 53 identified complications, 40% were recorded by only one registry, and 56% of those collected by more than one registry had different definitions. This diversity in reporting complicates reliable benchmarking, emphasizing the need for standardization in complication reporting across trauma registries.

Journal Article by Lee A, Kroeker J and Evans DC in Am J Surg

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Key findings from documentation of trauma-informed care for young assault trauma patients

Post author By STITCHES Newsletter
Post date 26/02/2024
Categories In Appendix, Gallbladder and Surgical Emergencies, General Surgery, Pediatric Surgery

Results from a retrospective chart review show that 96% of pediatric assault trauma patients had at least one trauma-informed element documented, compared to 82.5% of adult patients. Social workers were the most likely to document trauma-informed elements, with pain assessment and social support being the most frequently documented. However, safety assessments for suicidal ideation, retaliatory violence, and firearm access were rarely documented, highlighting opportunities for developing trauma-informed interventions to mitigate risks of violent reinjury.

Journal Article by Zufer I, Fix RL (…) Hoops K et 4 al. in J Surg Res

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Adjuvant Chemotherapy Improves 5-Year Survival in Near-Pathological Complete Response Patients with Locally Advanced Rectal Cancer

Post author By STITCHES Newsletter
Post date 26/02/2024
Categories In General Surgery, Intestine and Lower Gastrointestinal Tract

Patients achieving near-pathological complete response in locally advanced rectal cancer benefited from adjuvant chemotherapy, particularly those with ypt1-t2 stage tumors and positive lymph nodes. Act was associated with improved 5-year disease-free survival rates in downstage patients, emphasizing its significance in post-surgery outcomes. Additionally, serum carcinoembryonic antigen levels before treatment and ypT stage were identified as independent factors influencing survival outcomes in near-pcr patients.

Journal Article by Cai Y, Chen M (…) Kang L et 4 al. in Eur J Surg Oncol

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Identification of low-risk surgical candidates for small intestinal neuroendocrine tumors through combined imaging

Post author By STITCHES Newsletter
Post date 26/02/2024
Categories In General Surgery, Intestine and Lower Gastrointestinal Tract, Sarcoma & rare tumors

A tailored diagnostic protocol using contrast-enhanced computed tomography enterography and 68 Ga dotatate PET/CT showed high sensitivity and specificity in detecting primary small intestinal neuroendocrine tumors (SI-NETs) and distal lymph node disease. The combined imaging allowed for the identification of low-risk surgical candidates with single SI-NET lesions and distal lymph node disease preoperatively, enabling potential implementation of minimally invasive surgery in these cases.

Journal Article by Bonomi A, Fumagalli Romario U (…) Bertani E et 7 al. in Langenbecks Arch Surg

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