Perforated marginal ulcer after gastric bypass for obesity: a systematic review.

Marginal ulcers are a recognized complication of gastric bypass procedures for obesity. Perforated marginal ulcer (PMU) is a life-threatening complication of marginal ulcers. We performed a systematic review to understand the presentation, management, and outcomes of PMUs.

Reliability of transcranial sonography for assessment of brain midline shift in adult neurocritical patients: a systematic review and meta-analysis.

Introduction: The aim of this systematic review and meta-analysis was to determine the reliability of transcranial sonography as an alternative to computed tomography for evaluation of brain midline shift in adult neurocritical patients.

Evidence Aquisition: The PubMed, EMBASE, Cochrane Library, Scopus and Web of Science databases were searched. Original studies evaluating brain midline shift in adult neurocritical patients using both transcranial sonography and computed tomography were eligible.

Optimising the outcomes of index admission laparoscopic cholecystectomy and bile duct exploration for biliary emergencies: a service model.

Aims: The rate of acute laparoscopic cholecystectomy remains low due to operational constraints. The purpose of this study is to evaluate a service model of index admission cholecystectomy with referral protocols, refined logistics and targeted job planning.

Methods: A prospectively maintained dataset was evaluated to determine the processes of care and outcomes of patients undergoing emergency biliary surgery.

Efficacy of dexmedetomidine as an adjuvant to Quadratus lumborum block for pediatrics undergoing laparoscopic pyeloplasty. A prospective randomized double blinded study.

Background: We designed this study to evaluate dexmedetomidine as an adjuvant to local anesthetics in Quadratus lumborum block (QLB) in pediatrics either interfascial versus intravenous on the quality of postoperative analgesia and incidence of side effects.

Methods: Fifty pediatric patients ASA I and II, from eight to thirteen years old posted for laparoscopic pyeloplasty were randomized either to: QLB dexmedetomidine intravenous (QD IV) group or QLB dexmedetomidine interfascial (QD IF) group. A 24-h postoperative morphine consumption (primary outcome), time to first analgesic request, postoperative pain and sedation scores were compared.

Gall Bladder Empyema: Early Cholecystectomy during the Index Admission Improves Outcomes.

Objectives: We aim to evaluate our policy of index admission management of gall bladder empyema and the effect of the timing of surgery on the outcomes.

Methods: We analyzed a series of 5400 laparoscopic cholecystectomies. Data were collected prospectively over 26 y.

Effects of local low-dose rocuronium on the quality of peribulbar anesthesia for cataract surgery.

Objectives: Peribulbar anesthesia is associated with delayed and/or incomplete orbital akinesia compared with retrobulbar anesthesia. This study examined the effects of adding rocuronium 5 mg to two different concentrations of lidocaine-bupivacaine mixture on onset time of orbital and eyelid akinesia in patients undergoing cataract surgery.

Methods: In a double-blind study, 90 patients were equally randomized to receive a mixture of 0.