Asian J Surg
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Randomized Controlled Trial Comparative Study
Outcomes of early versus delayed cholecystectomy in patients with mild to moderate acute biliary pancreatitis: A randomized prospective study.
In patients with acute biliary pancreatitis (ABP), cholecystectomy is mandatory to prevent further biliary events, but the precise timing of cholecystectomy for mild to moderate disease remain a subject of ongoing debate. The aim of this study is to assess the outcomes of early versus delayed cholecystectomy. We hypothesize that early cholecystectomy as compared to delayed cholecystectomy reduces recurrent biliary events without a higher peri-operative complication rate. ⋯ In mild to moderate ABP, early laparoscopic cholecystectomy reduces the risk of recurrent biliary events without an increase in operative difficulty or perioperative morbidity.
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Postoperative ileus (POI) is one of the most common reasons for sustained hospital stays after ileostomy repair. Although many factors have been investigated as POI risk factors, the investigation of the impact of prior abdominal surgery (PAS) before rectal cancer surgery has been limited. This study aimed to identify the impact of PAS as a risk factor for POI after ileostomy repair. ⋯ This study suggests that PAS before rectal cancer surgery is associated with POI after ileostomy repair.
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A 46-year-old man was admitted for emergent donor hepatectomy. His circulatory condition became unstable 75 minutes after induction and then deteriorated to ventricular fibrillation due to latex-induced anaphylaxis. ⋯ He was discharged home without any sequelae. Extracorporeal cardiopulmonary resuscitation would offer an alternative choice compared with conventional cardiopulmonary resuscitation.
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Surgical intervention might be required in secondary spontaneous pneumothorax (SSP) with prolonged air leak; however, operation under general anesthesia (GA) could be critical in compromised patients. In this study, we performed video-assisted thoracic surgery (VATS) under epidural anesthesia (EA) in compromised patients with SSP and evaluated its feasibility. ⋯ In case with patients having intractable SSP with compromised pulmonary function, VATS under EA could be an effective and safe option to approach the appropriate goals of air leak control and less recurrence of pneumothorax.
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Obturator hernia is rare type of abdominal hernia and its diagnosis usually is made intraoperatively for bowel obstruction or computed tomography (CT) scans of the abdomen. The aim of this study was to review patient's records with respect to clinical manifestation, CT scan findings, and operative outcomes. ⋯ The diagnosis of obturator hernia can be made by CT scan preoperatively, and the obturator hernia should be suspected when an unexplained bowel obstruction in elderly, thin women occurs.