Background: To access the feasibility, safety and success of day care laparoscopic cholecystectomy in a tertiary center in India.
Methods: This is a retrospective analysis of prospectively collected data between 2004 and 2009 from a tertiary center in north India. All patients of symptomatic gallstone diseases having age less than 70 years, American Society of Anesthesiologists (ASA) grade I and grade II, living within 20 Kilometers of the hospital, availability of a responsible adult care taker at home, access to a telephone and a means of transportation to hospital if needed, underwent laparoscopic cholecystectomy under the care of the two participating surgeons, were considered for day care laparoscopic cholecystectomy. Clinical and operative data were recorded prospectively. All patients were discharged 6 to 8 hours after surgery with the advice to contact the surgical team over phone whenever necessary or on the day after discharge.
Results: A total of 602 laparoscopic cholecystectomies were performed over a period of 6years, among them 309 (51.32%) were operated on day care basis. Nine patients in day care procedure group had conversion to open procedure (5 due to distorted anatomy of calot's triangle, 2 due to common bile duct stones, 1 due to bile duct injury and 1 due to bleeding from cystic artery stump). One patient had myocardial infarction and 3 had nausea and vomiting which failed to resolve by intravenous ondensteron and all these (13) patients (4.20%) needed unplanned admission to the hospital. Two hundred and ninety-six patients (95.79%) were discharged on same day.
Conclusions: In conclusion day care laparoscopic cholecystectomy is feasible, safe and equally effective in selected patients in Indian setup.
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http://dx.doi.org/10.4021/gr374w | DOI Listing |
Sci Rep
December 2024
Department of Anesthesiology, The First Hospital of Putian City, Putian, China.
This study aimed to investigate the relationship between unintentional weight loss and 30-day mortality in sepsis patients in the intensive care unit (ICU). A retrospective cohort study sepsis patients in the ICU was conducted using data from the Medical Information Mart for Intensive Care IV (MIMIC-IV) database, involving 1842 sepsis patients in the ICU. We utilized multivariate Cox regression analysis to evaluate the association between unintentional weight loss and the risk of 30-day mortality.
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December 2024
The Affiliated Wuxi People's Hospital of Nanjing Medical University, Wuxi People's Hospital, Wuxi Medical Center, Nanjing Medical University, Nanjing, China, 214000.
Individuals afflicted with heart failure complicated by sepsis often experience a surge in blood glucose levels, a phenomenon known as stress hyperglycemia. However, the correlation between this condition and overall mortality remains unclear. 869 individuals with heart failure complicated by sepsis were identified from the Medical Information Mart for Intensive Care-IV (MIMIC-IV) database and categorized into five cohorts based on their stress hyperglycemia ratio (SHR).
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December 2024
Princess Margaret Cancer Centre, University Health Network, Toronto, Canada.
Despite decades of improvements in cytotoxic therapy, the current standard of care for locally advanced pancreatic cancer (LAPC) provides, on average, only a few months of survival benefit. Stereotactic Body Radiation Therapy (SBRT), a technique that accurately delivers high doses of radiation to tumors in fewer fractions, has emerged as a promising therapy to improve local control of LAPC; however, its effects on the tumor microenvironment and hypoxia remain poorly understood. To explore how SBRT affects pancreatic tumors, we combined an orthotopic mouse model of pancreatic cancer with an intravital microscopy platform to visualize changes to the in vivo tumor microenvironment in real-time.
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December 2024
Department of Endocrinology and Metabolism, Chengdu First People's Hospital, No.18 North Vientiane Road, High-Tech Zone, Chengdu, 610000, Sichuan, China.
We aimed to determine the association between anion gap-to-calcium ratio (ACR) and 30-day mortality in sepsis patients with diabetes mellitus (DM). Data for sepsis patients diagnosed with DM was extracted from Medical Information Mart for Intensive Care Database IV. After screening, 4429 eligible subjects were included in our study finally.
View Article and Find Full Text PDFNPJ Prim Care Respir Med
December 2024
ResMed Science Center, San Diego, CA, USA.
Digital health platforms for asthma self-management have demonstrated promise in improving clinical and quality of life outcomes. However, few studies have examined such an approach in a real-world, fully remote setting. As such, we evaluated the benefit of an evidence-based digital self-management platform for asthma-both on its own and when integrated into an established virtual clinical service.
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