The British journal of surgery
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Review Meta Analysis
Meta-analysis of randomized controlled trials on the safety and effectiveness of early versus delayed laparoscopic cholecystectomy for acute cholecystitis.
: In many countries laparoscopic cholecystectomy for acute cholecystitis is mainly performed after the acute episode has settled because of the anticipated increased risk of morbidity and higher conversion rate from laparoscopic to open cholecystectomy. ⋯ : ELC during acute cholecystitis appears safe and shortens the total hospital stay.
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Randomized Controlled Trial Multicenter Study Comparative Study
Randomized clinical trial of laparoscopic gastric bypass versus laparoscopic duodenal switch for superobesity.
Laparoscopic Roux-en-Y gastric bypass (LRYGB) and laparoscopic biliopancreatic diversion with duodenal switch (LDS) are surgical options for superobesity. A randomized trial was conducted to evaluate perioperative (30-day) safety and 1-year results. ⋯ LRYGB and LDS can be performed with comparable perioperative safety in superobese patients. LDS provides greater weight loss in the first year.
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Comparative Study
Cost-utility and value-of-information analysis of early versus delayed laparoscopic cholecystectomy for acute cholecystitis.
: A recent systematic review found early laparoscopic cholecystectomy (ELC) to be safe and to shorten total hospital stay compared with delayed laparoscopic cholecystectomy (DLC) for acute cholecystitis. The cost-effectiveness of ELC versus DLC for acute cholecystitis is unknown. ⋯ : The results of this decision analytic modelling study suggest that on average ELC is less expensive and results in better quality of life than DLC. Future research should focus on quality-of-life measures alone.
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: This study evaluated the incidence of postoperative delirium (POD) in elderly patients undergoing general surgery, the risk factors associated with POD, and its impact on hospital stay and mortality. ⋯ : The incidence of POD is high in elderly patients for both emergency and elective surgery, leading to an increase in hospital stay and perioperative mortality. To minimize POD, associated risk factors of co-morbidity, cognitive impairment, psychopathology and abnormal glycaemic control must be identified and treated.