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RISS 인기검색어
- 검색키워드
- 저자 : ( Paleswan Joshi Lakhey ) (검색결과 2 건)
- 무료
- 기관 내 무료
- 유료
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Analysis of the Cases with Carcinoma Gallbladder (CA GB) in a Tertiary Level Hospital of Nepal
( Romi Dahal ),( Bika Lghimire ),( Prasan Kansakar ),( Ramesh Singh Bhandari ),( Paleswan Joshi Lakhey ) 대한간학회 2020 춘·추계 학술대회 (KASL) Vol.2020 No.1
Aims: Gallbladder cancer (GC) is a relatively rare disease in some parts of world but is common in countries like Chile, Japan India and Nepal. Nepal stands as one of the five countries with the highest mortality. Methods: A retrospective analysis of the consecutive operated and non-operated admitted cases of GC in TUTH from 2018 to 2019 was done. Patient demographics, disease characteristics, diagnostic modalities and various curative and palliative treatment variables were analyzed. Results: Of the 59 patients, there were 33 females (56%) who outnumbered the 26 males(44%) with a male to female ratio of 0.7:1. The median age at diagnosis was 56 years with younger group (<60 years) comprising 62.7% of the disease. Among all, the most common presenting symptom was abdominal pain followed by jaundice. Onset of first symptoms was within mean duration of 40 days (SD 37.45 days). USG and CT availability (100%) lead to preoperative diagnosis in majority. Curative resection (extended cholecystectomy) was done in 16 (27%). The most common anatomic location of mass was fundic followed by neck. Pathological examinations revealed most cases of adenocarcinoma. Of the advanced metastatic Ca GB in 30% of cases, the most common site of metastasis was liver. Mean survival after diagnosis in advanced cases was 4.5 months. Conclusions: CA GB is more common in Nepal, more among females and younger patients often presenting with pain abdomen and jaundice. Most are advanced at the time of diagnosis Radical surgery can be offered to few patients where the outcome seems reasonably good.
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Management of Choledochal Cyst: An Institutional Review from a Tertiary Referral Center in Nepal
( Sujan Shrestha ),( Bikal Ghimire ),( Prasan Kansakar ),( Ramesh Singh Bhandari ),( Paleswan Joshi Lakhey ) 대한간학회 2020 춘·추계 학술대회 (KASL) Vol.2020 No.1
Aims: Choledochal cysts (CC) are a rare congenital cystic dilation of the biliary tract. Methods: This is a retrospective study of 32 consecutive patients of CC who underwent multidisciplinary management in last 2 and half years at a tertiary referral center from Nepal. Results: A total of 32 patients, 9 males and 23 females were operated. The average age at diagnosis was 25 years (range from 2 to 56 years). The most common presenting symptoms were pain 31(96.88%), jaundice 10(31.25%) and mass 5 (15.63%). Triad of pain, jaundice and mass was present in 4 (12.5%). Transabdominal Ultrasonography (100%) was the initial diagnostic modality of choice followed by MRCP (68.75%), and CECT (31.25%). ERCP was done for stent placement in 3 (9.38%) patients with severe cholangitis. Type IVA (37.5%) was the most common type of CC followed by type IC (31.23%), type IB (15.65%), type IA (12.5%) and type IVB (3.12%). Abnormal pancreaticobiliary duct junction was observed in 3 (9.38%) patients. All patients underwent open cyst excision with Roux-en-Y hepaticojejunostomy (HJ). There were 2 patients who underwent relaparotomy for efferent loop obstruction and Peterson hernia. None of our patient had cholangiocarcinoma on pathological examination. Conclusions: Choledochal cyst is rare cystic dilatation of biliary tract. Surgery (Cyst excision with Roux-en-Y hepaticojejunostomy) is treatment of choice. Although the incidence of cholangiocarcinoma is less, long-term surveillance is essential.
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