The effects of repeat laparoscopic surgery on the treatment of complications resulting from laparoscopic surgery.

Laparoscopic surgery is frequently applied in the operative management of appendicitis and symptomatic cholelithiasis because it is a minimally invasive procedure. There are, however, some complications of laparoscopic cholecystectomy (LC) and laparoscopic appendectomy (LA) that result in the need for reoperation. In the current study, we examine the effects of repeat laparoscopic surgery on the treatment of complications arising from LC/LA.

Anterior-posterior compression pelvic fracture increases the probability of requirement of bilateral embolization.

Introduction: Transarterial embolization has become an effective method in the management of pelvic fracture-related retroperitoneal hemorrhage. However, the selection of bilateral embolization or selective unilateral embolization remains controversial. The anterior-posterior compression (APC) pelvic fracture creates a complete diastasis of the anterior pelvis, which might be associated with bilateral sacroiliac joint injuries and further bilateral arterial injuries.

Laparoscopic management for Seprafilm-induced sterile peritonitis with paralytic ileus: report of 2 cases.

Postoperative adhesions after abdominopelvic surgery can be prevented with the use of mechanical barriers such as Seprafilm membranes. However, this procedure is not without complications. Herein are reported 2 cases of Seprafilm-associated sterile peritonitis after gynecologic surgical procedures.

Laparoscopic common bile duct exploration in patients with complicated cholecystitis: a safety and feasibility study.

Background: Laparoscopic cholecystectomy (LC) with common bile duct exploration (LCBDE) is nowadays a preferred one-stage treatment. However, the influence of complicated cholecystitis (CC) on LCBDE has rarely been addressed. In the present study we aimed to verify whether severe gallbladder inflammation would adversely affect the outcome of LCBDE.

Late initiation of continuous veno-venous hemofiltration therapy is associated with a lower survival rate in surgical critically ill patients with postoperative acute kidney injury.

There is controversy about the appropriate timing for renal replacement therapy in patients with acute kidney injury (AKI). We are interested in the appropriate timing for initiation of continuous renal replacement therapy in critically ill surgical patients with postoperative acute kidney injury. Seventy-three critically ill surgical patients with postoperative AKI who received continuous renal replacement therapy (CRRT) were enrolled.

Selective computed tomography and angioembolization provide benefits in the management of patients with concomitant unstable hemodynamics and negative sonography results.

Background: The FAST (focused assessment of sonography for trauma) examination can rapidly identify free fluid in the abdominal or thoracic cavity, which is indicative of hemorrhage requiring emergency surgery in multiple-trauma patients. In patients with negative FAST examination results, it is difficult to identify the site of the hemorrhage and to plan treatment accordingly. We attempted to delineate the role of selective computed tomography (CT) and transarterial angioembolization (TAE) in the management of such unstable patients.

Tomographic findings are not always predictive of failed nonoperative management in blunt hepatic injury.

Background: Nonoperative management (NOM) has become the standard treatment of blunt hepatic injury (BHI) for stable patients. Contrast extravasation (CE) on computed tomography (CT) scan had been reported as a sign that is associated with NOM failure. The goal of this study was to further investigate the risk factors of NOM failure in patients with CE on CT scan.

Laparoscopic appendectomy provides better outcomes than open appendectomy in elderly patients.

The incidence of acute appendicitis in elderly patients is increasing due to prolonged life span. The associated morbidity and mortality related to perforation of acute appendicitis continue to present challenges to physicians. The role of laparoscopic appendectomy is still controversial.

Laparoscopic simple closure alone is adequate for low risk patients with perforated peptic ulcer.

Background: Helicobacter pylori (H.P.) eradication has led to a significant decline in peptic ulcer prevalence; however, the number of patients requiring surgical intervention remains relatively unchanged.

Angioembolization provides benefits in patients with concomitant unstable pelvic fracture and unstable hemodynamics.

Introduction: Pelvic fractures result in hemodynamic instability in 5% to 20% of patients, and the reported mortality rate is 18% to 40%. Previous studies have reported the application of angioembolization in pelvic fracture patients with a systolic blood pressure (SBP) less than 90 mm Hg, a fluid resuscitation requirement of more than 2000 mL, or a blood transfusion of more than 4 to 6 units within 24 hours. In the current study, we attempted to delineate the efficacy and outcome of angioembolization in unstable pelvic fracture patients with concomitant unstable hypotension status.

Higher glucose on admission is associated with need for angioembolization in stable pelvic fracture.

Background: Angioembolization is an effective adjunct to the management of retroperitoneal hemorrhage in pelvic fractures. Most patients with stable-type pelvic fracture are treated conservatively. However, in some stable pelvic fracture cases, patients should receive angioembolization for hemostasis upon incidental finding of contrast extravasation on computed tomography (CT).

Diagnostic accuracy, biohazard safety, and cost effectiveness-the Lodox/Statscan provides a beneficial alternative for the primary evaluation of patients with multiple injuries.

Background: Lodox/Statscan is a new digital X-ray machine with a low dose of radiation exposure that provides rapid, whole-body scans. In the setting of acute trauma management, the importance of image study is well recognized. Here, we report the accuracy of diagnoses made using Lodox/Statscan in patients with multiple injuries.

Evaluation of need for operative intervention in blunt splenic injury: intraperitoneal contrast extravasation has an increased probability of requiring operative intervention.

Background: Angioembolization is an effective adjunct to the management of blunt splenic injuries (BSI) that are not surgically treated. However, in some cases patients are unable to undergo angioembolization due to changes in their hemodynamic condition. In this study we attempt to define the characteristics of patients who need angioembolization in high-grade BSI.

Evaluation of need for angioembolization in blunt renal injury: discontinuity of Gerota's fascia has an increased probability of requiring angioembolization.

Background: Angioembolization is an effective adjunct in the management of high-grade renal injuries not surgically treated. However, in some cases, the bleeding may stop spontaneously, without the need for embolization. The aim of this study was to define the characteristics of patients who need angioembolization for high-grade blunt renal injuries (BRIs).