Are postoperative complications related to resident sleep deprivation?

This real-world study compares the outcome of surgery and the sleep-deprivation status of the resident surgeon. Residents who operated the day after a 24-hour on-call period were considered sleep deprived; all other resident surgeons were considered non-sleep-deprived. We retrospectively reviewed data on 6,371 surgical cases and identified 351 postoperative complications.

Obstructive jaundice caused by hepatoma fragments in the common hepatic duct.

A 67-year-old black male diabetic who had never consumed alcohol presented with anorexia, weakness, weight loss, and jaundice. Ultrasound demonstrated common bile duct obstruction; computed tomography scanning revealed multiple liver masses; endoscopic retrograde cholangiopancreatography showed a filling defect; aortogram confirmed the neovascularity of tumor proliferation; and percutaneous transhepatic cholangiography confirmed high-grade common duct obstruction. Operative intervention demonstrated hepatocellular emboli to the common bile duct causing obstruction.