Acute care surgery: a means for providing cost-effective, quality care for gallstone pancreatitis
Modern practice guidelines recommend index cholecystectomy (IC) for patients admitted with gallstone pancreatitis (GSP). However, this benchmark has been difficult to widely achieve. Previous work has demonstr...
In this study, an accurate, sensitive, and selective analytical method was developed and successfully applied to assess the pharmacokinetic behavior of trepibutone in rats. Trepibutone and carbamazepine (internal standard, IS) were quantified using multiple reaction monitoring (MRM) mode with the transitions of m/z 311.09→265.08 and m/z 237.06→194.08, respectively. The linearity, precision, accuracy, extraction recovery, matrix effect, and stability of the established method were all excellent within acceptable range. A total of 30 metabolites were identified in plasma and urine by Q-Exactive high resolution mass...
Conclusion: Early laparoscopic cholecystectomy is safe and effective for patients with MAGP, but the indications and contraindications must be strictly controlled.
Introduction: Early cholecystectomy shortly after admission for mild gallstone pancreatitis has been proposed based on observational data. We hypothesized that cholecystectomy within 24 hours of admission versus after clinical resolution of gallstone pancreatitis that is predicted to be mild results in decreased length-of-stay (LOS) without an increase in complications. Methods: Adults with predicted mild gallstone pancreatitis were randomized to cholecystectomy with cholangiogram within 24 hours of presentation (early group) versus after clinical resolution (control) based on abdominal exam and normalized laborat...
CONCLUSION: EC following mild gallstone pancreatitis does not increase the risk of intraoperative or postoperative complications, but reduces the readmission rate for recurrent biliary complications. PMID: 31268184 [PubMed - as supplied by publisher]
CONCLUSIONS: In patients diagnosed with acute gallstone pancreatitis, it is reasonable to proceed directly to surgery using intraoperative cholangiography on the same admission as the definitive assessment of the common bile duct. This negates the need for magnetic resonance cholangiopancreatography and can translate into cost savings and reduced length of stay. PMID: 31155897 [PubMed - as supplied by publisher]
Population aging and comorbidity are leading to an increase in patients unfit for cholecystectomy.
CONCLUSION: Acute biliary pancreatitis related to pregnancy is not limited to pregnant women, and the incidence of these cases was greater than expected. Acute biliary pancreatitis related to pregnancy can be successfully managed with conservative treatment because it usually has a mild to moderate clinical course. However, the surgeon should keep an early cholecystectomy in mind for patients other than those in the first trimester. PMID: 31135938 [PubMed - in process]
ConclusionThe current trend of gallstones in adolescent children seems to be a disease primarily of adolescent girls. Symptomatic idiopathic gallstones in adolescents are associated with high rates of common bile duct obstruction and pancreatitis and consequently warrant an early cholecystectomy for all adolescents.Level of EvidenceLevel IV Treatment Study.
Conclusion: Patients with complicated acute pancreatitis with infected pancreatic necrosis represent a challenge in their treatment due to the serious nature of the condition and the morbidity associated with it. A therapeutic option is presented with the combined use of negative pressure therapy (ABThera™) and mesh-mediated fascial traction. With this report we propose a potential line of research to determine its role in the treatment of these patients, as well as their possible advantages and complications. PMID: 30768066 [PubMed - in process]
CONCLUSIONS: This review confirms that postoperative minor biliary injuries can be successful managed by endoscopic ERCP biliary decompression. KEY WORDS: Bile leak, Bile duct injury, Biliary fistula, Endoscopy, ERCP, Laparoscopic cholecystectomy. PMID: 30588923 [PubMed - as supplied by publisher]