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장태수(Tae Soo Chang),홍윤범(Yun Beom Hong),백영국(Young Gook Back) 대한소화기학회 1993 대한소화기학회지 Vol.25 No.6
N/A The conventional open cholecystectomy has been done for 100 years as standard precedure for the gallbladder disease. Minilapartomy chrolecystectomy, which is defined as a cholecystectomy through a small skin incision less than 10 cm of the wound length in our case, was performed by Jonathan R. Merill in 1988 with the advantage of early recovery, early return to work, economic profit, minute wound scar and less postoperative wound pain. To compare the result of minilaparotomy cholecystectomy and conventional choecystectomy, we performed minilaparotomy cholecystectomy in 43 cases of gallbladder disease from January 1991 to December 1992 at Department of Surgery, Masan Koryo General Hospital. In our study, male to female ratio was 1:2.9 and mean age was 44 years. All patients were preoperatively diagnosed as gallbladder disease by ultrasonography. Postoperative diagnosis were chronic cholecystitis with gallstone in 37 cases, cholelithiasis only in 4, tubular adenoma in one and chronic cholecystitis with inflammatory polyp in another one. The mean operation time was 60 minutes and the mean hospital stay was 4.5 days. Nearly all patients (93.4%) required analgesics for wound pain on postoperative day (POD) 1 and 2, but five were given analgesics until POD 3. The postoperative complication was nearly absent except one of mild upper respiratory infection. The mean duration of return to work was 16.1 days. The conversion of minilaparotomy to conventional cholecystectomy was done in 2 cases because of preoperative misdiagnosis. According to this result, we would like to conclude that minilaparotomy cholecytectomy is a good and recommendable procedure to gallbladder disease.
약물에 의한 무과립구중에 동반된 급성 맹장염(Acute Typhlitis) 1 예
윤명순,정유성,이시래,배현호,장인득,이종명,허동,홍윤범,허길,이종명 대한내과학회 1997 대한내과학회지 Vol.52 No.5
Increasingly aggressive chemotherapy regimens, advances in transplantation technology, and the acquired immunodeficiency syndrome have resulted in a growing number of immunocompromised patients. Infections are a major cause of morbidity and mortality in this population. One of the most ominous complications is the development of typhlitis in this immunocompromised patients. Treatment of this process is controversial, and no consensus has emerged. We report a case of typhlitis who complicated agranulocytosis after exposure to drugs to treat $quot;flu$quot; like illness and recovered completely after two operations of appendectomy and ileocolectomy. Reviewing articles and this case, the favorable outcome seemed to be related to following three factors recognition of the acute surgical abdomen by abdominal CT scan, a prompt return of normal circulating white cells by the use of Granulocyte Colony Stimulating Factor and discontinuation of causative drugs, and an appropriately timed surgical intervention.