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William traverso md idaho3/30/2023 ![]() ![]() The aim of this study is to asses the applicability, safety, benefits and complications of the laparoscopic approach in patients with acute cholecystitis, as well as the development of this technique in the emergency surgery department of a tertiary hospital, compared to laparotomy. The application of the laparoscopic technique in acute cholecystitis is still subject to controversy. Las complicaciones locales y globales se correlacionaron significativamente con el tiempo transcurrido entre el inicio de los síntomas agudos y la cirugía, así como con el estado anatomopatológico de la vesícula biliar.Įl abordaje laparoscópico va adquiriendo un papel cada vez más primordial en el tratamiento de esta dolencia, convirtiéndose en nuestro hospital en la principal opción quirúrgica. Las complicaciones postoperatorias a lo largo de estos cuatro años en la vía laparoscópica han experimentado un descenso, pasando de un 21,42 a un 11,3%. La estancia media (englobando complicadas y no complicadas) hablan a favor del abordaje laparoscópico frente al abierto (mostrando una diferencia de aproximadamente 6 al día). Se han intervenido 253 pacientes por vía laparoscópica, 101 por vía abierta, apreciándose un predominio del sexo masculino (57,67%) y una edad media de 62,83 años.Įl número de colecistectomía laparoscópica ha pasado del 60% en el 2006, al 79% en 2009. El objetivo del estudio es valorar la aplicabilidad, seguridad, beneficios y complicaciones del abordaje laparoscópico en pacientes con colecistitis aguda, así como la evolución y desarrollo de dicha vía en la unidad de cirugía de urgencias de un hospital de tercer nivel, en comparación con la laparotómica.Įl estudio consta de 354 pacientes con cuadros de colecistitis aguda intervenidos por vía abierta o laparoscópica desde 2006 a 2009. La aplicación de la técnica laparoscópica en la colecistitis aguda es aún hoy un tema controvertido. ![]() We identified areas for cost savings by substituting lesser cost alternatives without compromising the quality of patient care. Much of the cost difference can be accounted for by a relatively small number of high-cost instruments. Significant variation in direct cost exists between surgeons performing laparoscopic cholecystectomy. Compared with group A, surgeons in group B used reusable instruments more often and tended to choose lower-cost disposables. The difference persisted in subgroup analyses of both inpatients and patients with high American Society of Anesthesiologists scores. The average supply cost per case in group A was significantly greater than group B ($930 vs. The cost for each item was identified, and utilization was compared between groups. Two groups were created, with the 4 highest-cost surgeons comprising group A and the 2 lowest-cost surgeons comprising group B. The purpose of this study was to determine the reasons for cost variation between high- and low-cost surgeons and identify opportunities for cost reduction.Īverage cost of supplies per case was examined for laparoscopic cholecystectomy during a 6-month period. Direct supply cost per case varied from $524 to $1,022 among 14 surgeons. We performed 163 laparoscopic cholecystectomies at our institution during the third quarter of 2016. ![]()
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