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- 저자 : ( Toar Jm Lalisang ) (검색결과 2 건)
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( Arnetta Nl Lalisang ),( Toar Jm Lalisang ),( Perwira Widianto ),( Wifanto S Jeo ),( Yarman Mazni ),( Febiansyah Ibrahim ) 대한간학회 2020 춘·추계 학술대회 (KASL) Vol.2020 No.1
Aims: Laparoscopic cholecystectomy technique has changed the way surgeons treat cholelithiasis. The Global incidence of BDI has remained constant around 0.5%. BDI often encountered during laparoscopy cholecystectomy. Early diagnosis and appropriate management played an important role in managing BDI injuries. Methods: We aim to retrospectively review the management of BDI cases after laparoscopic cholecystectomy in CMH between 2015-2019. Results: We found 16 cases in this study with 10 females and 6 males. All subjects were a referral from primary or secondary health-care hospital The median age was 47 (25-58). Seven cases sustained BDI from laparoscopic procedure four were classified as Strassberg E3, one as Strasberg type A, one as Strasberg D, and 9 cases were BDI from the open procedure. All cases from laparoscopy procedure experience biloma. Hepaticojejunostomy Roux-en-Y was performed in all cases. One relaparotomy was performed due to bile anastomosis leakage. Conclusions: Proper demonstration of the anatomy may help to reduce BDI injuries. Early diagnosis and appropriate management played an important role in managing BDI injuries.
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( Vania Myralda G Marbun ),( Toar Jm Lalisang ) 대한간학회 2020 춘·추계 학술대회 (KASL) Vol.2020 No.1
Aims: LDLT are obtained from MRCP and IOC. Bile leakage as one of the important complications can be minimised by detail acknowledgment of biliary anatomy by combining MRCP and IOC. This study aims to review donors’ biliary anatomy and the impact of the acknowledgment to technique and duration. Methods: This single centre retrospective study included 46 adult-to-pediatric and 7 adult-to-adult LDLTs performed in Cipto Mangunkusumo Hospital from 2010-2019. All patients were performed MRCP then synchronised with IOC. All results were classified by Huang Classification. Demographic data, surgical technique, duration, and radiologic discrepancy were collected. Results: There are 34 cholangiographies out of 53 LDLTs. No biliary complications detected. Forty-nine donors underwent left-lateral sectionectomy and 4 right hepatectomy. Operative duration ranged from 270-600 minutes. The frequency of each type on MRCP/IOC are as follows: Huang A1 40,5%/35,1%; Huang A2 37,8%;37,8%; Huang A3 13,5%/18,9%; Huang A4 5,4%/8,1%; and Huang A5 2,7%/0. Huang A1 has the shortest operative duration and the least blood loss (70cc). Huang A3 has the longest operative duration with the most blood loss (900cc). Discrepancy were found in 6 patients of which 2 underwent longest operative duration and lost the most blood. Conclusions: Synchronised MRCP and IOC decrease operative duration therefore associated with better outcome. Low discrepancy showed that surgeon does not require nephrotoxic contrast media used in IOC hence reducing surgical duration except for rare cases like Huang A4 and A5 to avoid ligation of major intrahepatic duct.
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