The American surgeon
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The American surgeon · Jan 1991
Randomized Controlled Trial Clinical TrialOutpatient cholecystectomy simulated in an inpatient population.
This prospective clinical trial evaluates the feasibility and safety of elective cholecystectomy in a simulated outpatient protocol in 40 patients. Results were compared with a 19-patient control group managed by conventional postoperative methods. Oral liquids were begun in the recovery room, intravenous fluids were discontinued 4 hours after surgery, and enteral analgesics and antiemetics were provided on the ward. ⋯ No major complications occurred. Outpatient cholecystectomy is both feasible and safe. Metoclopramide may allow earlier tolerance of enteral liquids postoperatively.
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The records of 138 patients admitted a Glasgow Coma Score (GCS) of 14 or 15 following head injury were reviewed to assess the need for hospital observation and to determine whether obtaining a normal computerized tomography (CT) scan in the emergency department could have avoided admission. GCS was 15 in 103 patients (74%) and 14 in 35 (26%). Eighty-three patients were admitted for their head injury alone, and 55 had other injuries but would have required admission for their head injury. ⋯ Significant CNS pathology does occur following "minimal" head injuries. Skull x rays are not helpful. The use of CT scanning appears to triage those patients requiring admission and in hospital observation.