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Ambulatory cholecystectomy without disability.

Abstract

This is a presentation of 200 consecutive outpatient cholecystectomies performed during a 4-year period in a small community hospital. This technique is performed with minor modifications of the usual cholecystectomy procedure so that it could easily be performed by general surgeons throughout the United States. The procedure has resulted in a large reduction in the short- and long-term morbidity associated with cholecystectomy, and in savings of up to one fourth the cost of a routine inpatient cholecystectomy. This procedure allows the general surgeon to treat patients with cholecystectomies in the fashion to which the surgeon is accustomed and still markedly reduce the hospital stay. The morbidity from this procedure seems comparable with laser cholecystectomy. Ambulatory cholecystectomy as described here does not require any special training or equipment.

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BibTeXRIS

W P Ledet. 1990. Ambulatory cholecystectomy without disability.. https://doi.org/10.1001/archsurg.1990.01410230028004

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The role of gait analysis in the orthopaedic management of ambulatory cerebral palsy.

PURPOSE OF REVIEW: The literature was reviewed to describe the role of gait analysis in the orthopaedic management of ambulatory children with cerebral palsy and examine the current best evidence to support these roles. RECENT FINDINGS: Gait laboratory analysis is superior to visual or observational analysis of gait because it provides an objective record of gait that is able to quantify the magnitude of deviations of pathologic gait from normal and also explain these abnormalities. Recognizable gait patterns can be classified and used for making treatment decisions, the effectiveness of which can be assessed using gait analysis as a measure of gait outcomes. There are many sources of variability, however, including patients themselves, the gait laboratories and testing processes, interpretation of data and surgeons' surgical recommendations. SUMMARY: Although gait analysis has been shown to alter decision making, there is little evidence that the decisions based on gait analysis lead to better outcomes. Consequently, clinical gait analysis remains controversial, with wide variation in the rates of utilization of gait analysis in the management of children with ambulatory cerebral palsy. The time is ripe for clinical trials and cohort studies to provide the evidence to establish the appropriate utilization of this technology.

Ambulatory Surgical Procedures↗