The British journal of surgery
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Intravenous antibiotics are frequently used in the initial management of acute calculous cholecystitis (ACC), although supportive care alone preceding delayed elective cholecystectomy may be sufficient. This systematic review assessed the success rate of antibiotics in the treatment of ACC. ⋯ Antibiotics are not indicated for the conservative management of ACC or in patients scheduled for cholecystectomy.
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Mortality from laparoscopic antireflux surgery in a nationwide cohort of the working-age population.
Both medication and surgery are effective treatments for severe gastro-oesophageal reflux disease (GORD). Postoperative risks have contributed to decreased use of antireflux surgery. The aim of this study was to assess short-term mortality following primary laparoscopic fundoplication. ⋯ This population-based study revealed very low mortality and reoperation rates following primary laparoscopic fundoplication in the working-age population. The findings may influence clinical decision-making in the treatment of severe GORD.
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A large number of studies have examined the potential complications of calf deep vein thrombosis (DVT). There is no consensus on when or how to treat patients to prevent these complications. This systematic review assessed the rate of proximal propagation, pulmonary embolism, major bleeding and recurrence in patients with isolated calf DVT. ⋯ The literature on calf DVT is heterogeneous, limiting conclusions from data analysis. Adverse outcomes are infrequent and studies do not suggest that they are reduced by anticoagulation.
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Randomized Controlled Trial
Randomized clinical trial comparing self-gripping mesh with a standard polypropylene mesh for open inguinal hernia repair.
The introduction of mesh for open inguinal hernia repair has reduced the rate of recurrence, allowing research to focus on prevention of postoperative pain. In an effort to reduce chronic pain, a semiresorbable, lighter and self-gripping mesh was developed. ⋯ NTR1212 (http://www.trialregister.nl).