1. Post-Procedure Complications Monitoring Programme 39th Review Meeting
Friday, 21 March 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 Lai (Chairman)
Team 1 – Dr. Charing Chong & Dr. Bear Cho
Team 2 – Dr. Simon Wong & Dr. Sally Luk
Team 3 – Dr. Rachel Ko
Team 4 – Dr. Y F Yeung
PRAS – Dr. Kevin Mo
NS – Dr. Alberto Chu
PSU – Dr. Edwin Chan & Dr. Sammi Wong
URO – Dr. C K Chan & Dr. C H Samuel Yee
CTS – Dr. Micky Kwok
Mr. Alfred Chan
Ms Daisy Feng
Ms Eunice Tam

3. Items discussed
Complications report – January 2014
AOB

4. 1. Complications Report – January 2014

5. December 2014 Summary (case collection progress and Complication rate)
Complication rate and Magnitude
Team 1
Team 2
Team 3
Team 4
PRAS NS
PSUR
URO
CTS
Total
No. of Complication 11 4 5 3 7 13 55 51 47 64 43 56 73 53 65
516
Complication Rate
21.57%
8.51%
7.81%
6.98%
8.93%
9.59%
7.55%
4.69%
20.00%
10.66%

6. Team 1 – Hepato-biliary & Pancreatic Surgery

7. Team 1 – Hepato-biliary and Pancreatic Surgery ( Cont’d 2/6)
Grade 2

8. Team 1 – Hepato-biliary and Pancreatic Surgery ( Cont’d 3/6)
+ Septic shock

9. Team 1 – Hepato-biliary and Pancreatic Surgery ( Cont’d 4/6)
+ Septic shock
Delete either one

10. Outpatient Complication
Team 1 – Hepato-biliary and Pancreatic Surgery ( Cont’d 5/6)
Outpatient Complication

11. Team 1 – Hepato-biliary and Pancreatic Surgery ( Cont’d 6/6)
Open & closed
+ Septic shock
+ I.O

12. Team 2 – Upper Gastro-intestinal Surgery

13. Team 2 – Upper Gastro-intestinal Surgery ( Cont’d 2/4)
M & M

14. Daisy to follow up on the length of stay
Team 2 – Upper Gastro-intestinal Surgery ( Cont’d 3/4)
not aware of poor renal function upon admission
no renal protection before CT
M & M 4
- Delay presentation
Successful case with ICU support
Daisy to follow up on the length of stay

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

16. Team 3 – Colorectal Surgery

17. Team 3 – Colorectal Surgery ( Cont’d 2/4)

18. Team 3 – Colorectal Surgery ( Cont’d 3/4)
ESBL E Coli
(i.e. Still escape from prophylactic antibiotic – augmentin)

19. Team 3 – Colorectal Surgery ( Cont’d 4/4)

20. Team 4 – Vascular Surgery

21. Team 4 – Vascular Surgery (Cont’d 2/3)

22. Complication : Aspiration
Team 4 – Vascular Surgery (Cont’d 3/3)
No Discharge summary
Poor pre-morbid status with ongoing ischaemia
Complication : Aspiration

23. Plastic, Reconstructive and Aesthetic Surgery

24. Plastic, Reconstructive and Aesthetic Surgery (Cont’d 2/4)
+ renal failure

25. Plastic, Reconstructive and Aesthetic Surgery (Cont’d 3/4)

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

27. Neurosurgery

28. Neurosurgery (Cont’d 2/5)
Complication of 1st OT
Should update 1st OT

29. + Catheter re-adjustment
Neurosurgery
(Cont’d 3/5)
+ Catheter re-adjustment

30. Neurosurgery (Cont’d 4/5)
Post-op bleeding
Remark : requiring ICP Insertion

31. Neurosurgery
(Cont’d 5/5)
No discharged summary a/v.

32. Paediatric Surgery & Paediatric Urology

33. Paediatric Surgery & Paediatric Urology (Cont’d 2/4)
Grade : 1
Grade 3b
Urinary leakage

34. Paediatric Surgery & Paediatric Urology (Cont’d 3/4)
Remarks in OT record that a stricture occurred 2 months after surgery

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

36. Urology

37. Urology (Cont’d 2/3)

38. Urology (Cont’d 3/3)
Died at ICU
Patient under renal medicine

39. Cardiothoracic Surgery

40. Cardiothoracic Surgery (Cont’d 2/11)

41. Cardiothoracic Surgery (Cont’d 3/11)
- No need for long term renal replacement therapy

42. Cardiothoracic Surgery (Cont’d 4/11)

43. Cardiothoracic Surgery (Cont’d 5/11)
Pathology : Rupture of descending aorta on Day 4
Unconventional procedure (because of very small femoral artery)

44. Cardiothoracic Surgery (Cont’d 6/11)

45. Cardiothoracic Surgery (Cont’d 7/11)

46. Cardiothoracic Surgery (Cont’d 8/11)
Index operation
A mortality case

47. Cardiothoracic Surgery (Cont’d 9/11)
Mortality due to advancement of disease
Dr. Kwok to update OT record from GA -> MAC

48. Cardiothoracic Surgery (Cont’d 10/11)
D / C on 12 Feb 14
D/C on 25 Feb 14
Dr. Kwok to follow-up on progress of patients after returning to Macau.

49. Cardiothoracic Surgery (Cont’d 11/11)

50. 2. AOB - Nil

51. THE END