ABSTRACT
This real-world study compares the outcome of surgery and the sleep-deprivation status of the resident surgeon. Residents who operated the day after a 24-hour on-call period were considered sleep deprived; all other resident surgeons were considered non-sleep-deprived. We retrospectively reviewed data on 6,371 surgical cases and identified 351 postoperative complications. The complication data were analyzed using logistic regression analysis, with outcome being the presence or absence of surgical complications. No statistically significant change in complication incidence was noted when the resident surgeon was sleep deprived.
Subject(s)
General Surgery/education , Internship and Residency/standards , Postoperative Complications/epidemiology , Sleep Deprivation , Work Schedule Tolerance , Clinical Competence , Hospitals, Teaching , Humans , Incidence , Logistic Models , Louisiana , Postoperative Complications/etiology , Retrospective Studies , Treatment OutcomeABSTRACT
A 67-year-old black male diabetic who had never consumed alcohol presented with anorexia, weakness, weight loss, and jaundice. Ultrasound demonstrated common bile duct obstruction; computed tomography scanning revealed multiple liver masses; endoscopic retrograde cholangiopancreatography showed a filling defect; aortogram confirmed the neovascularity of tumor proliferation; and percutaneous transhepatic cholangiography confirmed high-grade common duct obstruction. Operative intervention demonstrated hepatocellular emboli to the common bile duct causing obstruction. We review the literature on this problem.
