1. Post-Procedure Complications Monitoring Programme 45th Review Meeting
Friday, 19 September 2014
4:00 - 6:00pm, 4/F, Arthur K C Li Surgical Library
Lui Che Woo Clinical Sciences Building, PWH

2. Attendance Present Prof. Paul B S Lai (Chairman)
Team 1 – Dr. Sunny Cheung & Dr. Ray Hung
Team 2 – Dr. Simon K H Wong (Chair the 2nd half of meeting)
Team 3 – Dr. Hon Sok Fei & Dr. Eric Y F Cheung
Team 4 – Dr. Micah C K Chan
PRAS – Dr. Teresa Tan
NS – Dr. Emily K Y Chan
PSU – Dr. Edwin K W Chan & Dr. Vicky H Y Wong
URO – Dr. C K Chan
CTS – Prof. Calvin Ng
Mr. Alfred Chan
Ms. Daisy Feng
Mr. Philip Yeung
Ms. Eunice Tam

3. Items discussed
Complications report – July 2014
AOB

4. 1. Complications Report – July 2014

5. July 2014 Summary (case collection progress and Complication rate)
PRS NS
PSUR
URO
CTS
Dept. total
Total cases 69 57 75 44 51 45 81 64
537
Missing cases
Non-Discharged * 1 6 2 12
Complication rate and Magnitude
Team 1
Team 2
Team 3
Team 4
PRAS NS
PSUR
URO
CTS
Total
No. of Complication 9 8 6 4 1 2 11 53 69 57 75 44 51 45 81 64
537
Complication Rate
13.04%
14.03%
8.00%
9.09%
1.86%
15.69%
8.89%
2.47%
17.19%
9.87%

6. Team 1 – Hepato-biliary and Pancreatic Surgery

7. Team 1 – Hepato-biliary and Pancreatic Surgery ( Cont’d 2/8)

8. Team 1 – Hepato-biliary and Pancreatic Surgery ( Cont’d 3/8)
+ GI Leakage
+ Abdominal collection

9. Team 1 – Hepato-biliary and Pancreatic Surgery ( Cont’d 4/8)
Septum culture : ESBL E Coli
+ Pancreatic leakage

10. Dr. Ray Hung to feedback to surgeon
Team 1 – Hepato-biliary and Pancreatic Surgery ( Cont’d 5/8)
Dr. Ray Hung to feedback to surgeon
Add the endoscopic coding

11. Team 1 – Hepato-biliary and Pancreatic Surgery ( Cont’d 6/8)
Index operation
Same patient

12. Team 1 – Hepato-biliary and Pancreatic Surgery ( Cont’d 7/8)
Might consider a clamp vs no clamp study

13. Team 1 – Hepato-biliary and Pancreatic Surgery ( Cont’d 8/8)

14. Team 2 – Upper Gastro-intestinal Surgery

15. Team 2 – Upper Gastro-intestinal Surgery ( Cont’d 2/7)

16. Team 2 – Upper Gastro-intestinal Surgery
( Cont’d 3/7)

17. Team 2 – Upper Gastro-intestinal Surgery
( Cont’d 4/7)

18. Team 2 – Upper Gastro-intestinal Surgery ( Cont’d 5/7)
Delete case.
Not Index operation.

19. Team 2 – Upper Gastro-intestinal Surgery ( Cont’d 6/7)
Resolved quickly

20. Team 2 – Upper Gastro-intestinal Surgery
( Cont’d 7/7)

21. Team 3 – Colorectal Surgery

22. Team 3 – Colorectal Surgery
( Cont’d 2/6)

23. Team 3 – Colorectal Surgery
( Cont’d 3/6)

24. Team 3 – Colorectal Surgery (Cont’d 4/6)
Confirmed prophylactic antibiotics was given
Worth looking at the interval between 1st operation & reversal of ileostomy

25. Team 3 – Colorectal Surgery
( Cont’d 5/6)

26. Team 3 – Colorectal Surgery
( Cont’d 6/6)

27. Team 4 – Vascular Surgery

28. Team 4 – Vascular Surgery
( Cont’d 2/6)

29. Team 4 – Vascular Surgery
( Cont’d 3/6)

30. Patient had renal impairment
Team 4 – Vascular Surgery
( Cont’d 4/6)
M & M
Patient had renal impairment
Patient currently stayed in O&T
Need to enhance the communication with OT nurses on the preparation and set-up e.g. use of power injector of this kind of emergency

31. Team 4 – Vascular Surgery
( Cont’d 5/6)

32. Team 4 – Vascular Surgery
( Cont’d 6/6)

33. Plastic, Reconstructive and Aesthetic Surgery

34. Plastic, Reconstructive and Aesthetic Surgery
( Cont’d 2/8)

35. Plastic, Reconstructive and Aesthetic Surgery
( Cont’d 3/8)

36. Plastic, Reconstructive and Aesthetic Surgery
( Cont’d 4/8)

37. Plastic, Reconstructive and Aesthetic Surgery
( Cont’d 5/8)

38. Plastic, Reconstructive and Aesthetic Surgery
( Cont’d 6/8)

39. Plastic, Reconstructive and Aesthetic Surgery ( Cont’d 7/8)
Nerve palsy
Should alert assistant surgeon on this traction injury

40. Plastic, Reconstructive and Aesthetic Surgery
( Cont’d 8/8)

41. Neurosurgery

42. Neurosurgery
( Cont’d 2/8)

43. Neurosurgery
( Cont’d 3/8)

44. Neurosurgery
( Cont’d 4/8)
Same patient

45. Neurosurgery
( Cont’d 5/8)

46. Neurosurgery
( Cont’d 6/8)
Same patient

47. Neurosurgery
( Cont’d 7/8)

48. Dr. Emily Chan to follow-up on D/C summary
Neurosurgery
( Cont’d 8/8)
Dr. Emily Chan to follow-up on D/C summary

49. Paediatric Surgery & Paediatric Urology

50. Paediatric Surgery & Paediatric Urology
( Cont’d 2/5)

51. Paediatric Surgery & Paediatric Urology ( Cont’d 3/5)
Same patient

52. Paediatric Surgery & Paediatric Urology
( Cont’d 4/5)

53. Paediatric Surgery & Paediatric Urology
( Cont’d 5/5)

54. Urology

55. Urology
( Cont’d 2/5)

56. Urology
( Cont’d 3/5)

57. Urology
( Cont’d 4/5)

58. Urology
( Cont’d 5/5)

59. Cardiothoracic Surgery

60. Cardiothoracic Surgery
( Cont’d 2/12)

61. Cardiothoracic Surgery
( Cont’d 3/12)

62. Cardiothoracic Surgery
( Cont’d 4/12)

63. Cardiothoracic Surgery
( Cont’d 5/12)

64. Cardiothoracic Surgery ( Cont’d 6/12)
Still in HDU
1st operation on 27 Jun 14
+ chest infection

65. Cardiothoracic Surgery
( Cont’d 7/12)

66. Cardiothoracic Surgery ( Cont’d 8/12)
Died in NDH on 17 Sep 14

67. Cardiothoracic Surgery ( Cont’d 9/12)
Died in ICU
Not sure what went wrong
No positive culture

68. Cardiothoracic Surgery
( Cont’d 10/12)

69. Cardiothoracic Surgery
( Cont’d 11/12)

70. Cardiothoracic Surgery
( Cont’d 12/12)

71. 2. AOB

72. AOB M & M Cardiac aurest T4 (renal impairment), risk of renal part
develop hyperkaekaemia part alert on transfusion.

73. THE END