Emergency surgery updates in the management of appendicitis, cholecystitis, and intestinal perforations
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2025
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| author | Oliveira, Davi Mota Candido de Silva Junior, Eduardo Abrão da Barbosa, Paulo Henrique de Liandro, Wanessa Gabriela Prudente, Sumaya Vieira Canedo Menezes, Luna Santos de Rodrigues, Luiz Antônio Rosa Simão |
| author_facet | Oliveira, Davi Mota Candido de Silva Junior, Eduardo Abrão da Barbosa, Paulo Henrique de Liandro, Wanessa Gabriela Prudente, Sumaya Vieira Canedo Menezes, Luna Santos de Rodrigues, Luiz Antônio Rosa Simão |
| contents | <p>To review and synthesize updates (last five years) in the surgical and non-surgical management of acute appendicitis, acute cholecystitis, and intestinal perforations, emphasizing indications, timing of intervention, the role of antibiotic therapy, source control, and management in septic patients. Methods: Narrative review of guidelines, randomized controlled trials, meta-analyses, and systematic reviews indexed in PubMed/PMC, SciELO, and international databases between 08/2020 and 08/2025. </p> <p>Results: (1) Appendicitis: Appendectomy remains the standard in most scenarios; however, non-operative antibiotic therapy is a selected option for uncomplicated appendicitis with well-defined criteria. Recent evidence shows higher recurrence rates but lower immediate morbidity in some RCTs. </p> <p>(2) Acute cholecystitis: A consolidated trend toward early cholecystectomy (preferably laparoscopic) in operable patients, guided by severity classification (Tokyo Guidelines), with percutaneous drainage/cholecystostomy as an option for high-risk patients. </p> <p>(3) Intestinal perforations/peritonitis: Emphasis on early source control, aggressive resuscitation, and “damage control” strategies when indicated; limited role for open abdomen, reserved for specific situations. </p> <p>Conclusion: Modern management favors individualized decisions integrating risk stratification, diagnostic imaging, guided empirical antibiotic therapy, and early source control; gaps remain regarding optimal selection for non-operative treatment in appendicitis and early criteria for “damage control” surgery. </p> |
| format | Recurso digital |
| id | zenodo_https___doi_org_10_5281_zenodo_17283877 |
| institution | Zenodo |
| language | eng |
| publishDate | 2025 |
| publisher | Zenodo |
| record_format | zenodo |
| spellingShingle | Emergency surgery updates in the management of appendicitis, cholecystitis, and intestinal perforations Oliveira, Davi Mota Candido de Silva Junior, Eduardo Abrão da Barbosa, Paulo Henrique de Liandro, Wanessa Gabriela Prudente, Sumaya Vieira Canedo Menezes, Luna Santos de Rodrigues, Luiz Antônio Rosa Simão Acute Appendicitis Acute Cholecystitis Intestinal Perforation Peritonitis Source Control Emergency Surgery <p>To review and synthesize updates (last five years) in the surgical and non-surgical management of acute appendicitis, acute cholecystitis, and intestinal perforations, emphasizing indications, timing of intervention, the role of antibiotic therapy, source control, and management in septic patients. Methods: Narrative review of guidelines, randomized controlled trials, meta-analyses, and systematic reviews indexed in PubMed/PMC, SciELO, and international databases between 08/2020 and 08/2025. </p> <p>Results: (1) Appendicitis: Appendectomy remains the standard in most scenarios; however, non-operative antibiotic therapy is a selected option for uncomplicated appendicitis with well-defined criteria. Recent evidence shows higher recurrence rates but lower immediate morbidity in some RCTs. </p> <p>(2) Acute cholecystitis: A consolidated trend toward early cholecystectomy (preferably laparoscopic) in operable patients, guided by severity classification (Tokyo Guidelines), with percutaneous drainage/cholecystostomy as an option for high-risk patients. </p> <p>(3) Intestinal perforations/peritonitis: Emphasis on early source control, aggressive resuscitation, and “damage control” strategies when indicated; limited role for open abdomen, reserved for specific situations. </p> <p>Conclusion: Modern management favors individualized decisions integrating risk stratification, diagnostic imaging, guided empirical antibiotic therapy, and early source control; gaps remain regarding optimal selection for non-operative treatment in appendicitis and early criteria for “damage control” surgery. </p> |
| title | Emergency surgery updates in the management of appendicitis, cholecystitis, and intestinal perforations |
| topic | Acute Appendicitis Acute Cholecystitis Intestinal Perforation Peritonitis Source Control Emergency Surgery |
| url | https://doi.org/10.5281/zenodo.17283877 |