Bile leak in open cholecystectomy: related to gangrenous cholecystitis?

Background: Open cholecystectomy is still required for treatment of gallbladder disease when inflammation has changed the usual anatomic landmarks and make laparoscopic cholecystectomy unsafe or technically impossible.

Methods: In this study, we reviewed all the records of patients who underwent open or laparoscopic-converted-to-open cholecystectomy between January 2000 and August 2006.

Results: A total of 3367 patients underwent cholecystectomies.

'Normal' vital signs belie occult hypoperfusion in geriatric trauma patients.

Base deficit (BD) and lactic acid (LA) are accepted markers of hypoperfusion and predictors of outcome in the trauma patient and we aim to assess the value of these markers in the triage of the elderly with "normal" vital signs. Patients older than age 65 who presented between 1997 and 2004 but who did not have isolated head injuries were included. Three patient groups were established: normal, occult hypoperfusion (OH), and shock.

Patterns of injury in geriatric falls.

Falls are the most common cause of trauma in the elderly. Data regarding patterns of injury following geriatric falls are scant. We conducted a retrospective review of falls in patients aged 65 years and older seen at a trauma center over a nine year period.

Vital capacity as a predictor of outcome in elderly patients with rib fractures.

Background: This study tests the relationships between early bedside vital capacity (VC) measurement and morbidity, mortality, and resource consumption in geriatric blunt chest trauma patients with rib fractures.

Methods: This was a retrospective study examining all patients > or = 65 years old with rib fractures who had a VC measured within 48 hours of their emergency department evaluation. Outcome variables included pulmonary complications, death from pulmonary complications, hospital length of stay (LOS), intensive care unit length of stay (ICU LOS), and discharge disposition.