jueves, 21 de agosto de 2014

Gallbladder surgery: have it right away or wait?

Gallbladder surgery: have it right away or wait?

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Gallbladder surgery: have it right away or wait?

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About 20 percent of all patients who are admitted to emergency rooms with gallbladder pain and are sent home to schedule surgery returned to the ER within 30 days needing emergency gallbladder removal. These are the results of a study conducted at the Mayo Clinic in Rochester (Minnesota) and published in the "Journal of Surgical Research".
Often it is obvious who needs emergency cholecystectomy, who can delay it and who doesn't need surgery at all. But sometimes patients fall into a gray area. Juliane Bingener-Casey and her colleagues therefore studied the records of 3,138 patients at Mayo between 2000 and 2013 who went to the emergency department for abdominal pain within 30 days before gallbladder surgery.
Of those, 1,625 were admitted for emergency gallbladder surgery, and 1,513 were allowed to go home and schedule surgery at a later date. Of the patients who went home, 20 percent came back to the emergency room within a month needing a cholecystectomy urgently, and of those, 55 percent were back in the ER within a week for emergency surgery.
Younger patients who were otherwise healthy and older patients who did have other health problems are more affected by this than people in their 40s and 50s. However, delaying a needed gallbladder removal more than six days increases the surgical complication rate and may make patients likelier to need open-abdomen surgery rather than a minimally invasive laparoscopic procedure, the researchers noted

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