Implementation of trans-cystic biliary stenting during acute cholecystectomy to facilitate elective ERCP: a quality improvement initiative.

Background: A predominantly endoscopic approach for acute admissions with choledocholithiasis with a gallbladder in situ (CGIS) resulted in prolonged hospital length of stay due to delays at investigation and treatment junctures. We initiated a quality improvement program of trans-cystic biliary stenting to facilitate efficient patient progress to acute cholecystectomy and outpatient ERCP if required.

Methods: We utilized implementation frameworks with regular re-assessment for this quality improvement project.

Managing the road safety risks of last mile deliveries: Do telematics have a role to play?

Objective: The research aimed to understand the impact of telematics in reducing traffic violations and crashes among drivers working in parcel delivery and the perceived utility, effectiveness, and acceptability of telematics among drivers using them. The objective was to carry out an online survey among drivers who have telematics versus drivers who do not and compare their behaviors in terms of risks and violations controlling for key demographics an exposure.

Methods: An online anonymous survey was conducted of 780 home delivery drivers of which 430 used telematics in 2022.

Determining the learning curve of minimally invasive antireflux surgery: systematic review, meta-analysis, and meta-regression.

The rapid uptake of minimally invasive antireflux surgery has led to interest in learning curves for this procedure. This study ascertains the learning curve in laparoscopic and robotic-assisted antireflux surgery. A systematic review of the literature pertaining to learning curves in minimally invasive fundoplication with or without hiatal hernia repair was performed using PubMed, Medline, Embase, Web of Science, and Cochrane Library databases.

Measurement of the distal bile duct density on computed tomography can differentiate choledocholithiasis from a control population.

Purpose: Hounsfield unit density of biliary fluid on CT may be a useful clinical marker that has not been described in the literature. This method has been used to differentiate pyonephrosis from hydronephrosis in obstructed collecting systems of the kidney. We aimed to create a user-friendly technique to measure the density of the distal bile duct using CT.