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간장 ( 肝臟 ) , 담도 ( 膽道 ) 및 췌장 ( 膵臟 ) : Expandable Metallic Stent를 이용한 담도 협착의 치료
민영일(Young Il Min),이성구(Sung Koo Lee),김명환(Myung Hwan Kim),이승규(Sung Gyu Lee),전용철(Yong Cheol Jeon),성규보(Kyu Bo Seong),민병철(Pyung Cheol Min) 대한소화기학회 1991 대한소화기학회지 Vol.23 No.3
N/A Expandable metallic stents were implanted in 9 patients with malignant (4 patients) or benign (5 patients) biliary stenoses. Five patients with benign strictures (intrahepatic stones with intrahepatic strictures, n=4; intrahepatic and extrahepatic stones with common bile duct stricture, n= 1) and four with malignant biliary strictures (cholangiocarcinoma, n=4) were treated with expandable metallic stents via percutaneous or transpapillary route. The patients with benign disease had failed treatment with surgical reconstruction and transhepatic balloon dilatation. In the three of the four patients with cholangiocarcinoma, relief of jaundice was observed. Patients with benign strictures have done very well. Our experience shows that expandable metallic stents can be inserted with little discomfort for the patients and with relatively few complications. They will provide good palliation in patients with malignant obstructive jaundice and benign strictures.
Cytomegalovirus감염이 동반된 Crohn대장염
민영일(Young Il Min),이영상(Young Sang Lee),김해련(Hae Ryun Kim),김명환(Myung Hwan Kim),정영화(Young Hwa Joung),김상위(Sang Wi Kim),김진천(Jin Chun Kim),이인철(In Chul Lee) 대한소화기학회 1990 대한소화기학회지 Vol.22 No.2
Crohn's colitis, a variety of chronic nospecific inflammatory bowel disease is a rare disease of unknown cause in Korea. Cytomegalovirus may cause primary boyrel inflammation mostly in immune-compromised host, and may aggravate the course of thd chronic imflmatory bowel disease. A 53 year old female, referred due to abdominal pain and diarrhea, had the evidence of cytomegalovirus infection in the ulcerated colonic mucosa, which was confirmed later as Crohn's disease of colon, pathologically. Case history was presented and reviewed.
급성 췌장염의 중증도 판정에 있어서 임상적 기준 ( Ranson 기준 ) 과 방사선학적 ( CT ) 기준의 비교 검토
민영일(Young Il Min),이성구(Sung Koo Lee),김병식(Byung Sik Kim),한동수(dong Soo Han),김명환(Myung Hwan Kim),이문규(Moon Kyu Lee),이선영(Sun Young Yi),이미화(Mi Hwa Lee),김미경(Mee Kyung Kim) 대한소화기학회 1993 대한소화기학회지 Vol.25 No.4
N/A The assessment of severity has a key role in the management of patients with acute pancreatits. A total of 55 patients were enrolled in this study. Ransons cinical severity was determined within 48 hours after admission and radiologic severity was determined based on Balthazar criteria using computed tomography (CT) scan taken not later than 2 hours after admission. The seventy of pancreatitis based on Ransons criteria was mild (0-2 signs) in 39 patients (71%), moderate (3-6 signs) in 10 (18%), and severe ( 7 signs) in 6(11%). with increase in Ranson's score, average days of fasting, hospitali#zation and ICU care were increased. The mortality rate was also increased with CT criteria, the: patients showed mild .;everity in 29 patients (53%) (A:18, B:11). moderate in 20(36%) (C:16, D:4), and severe in 6(11%) (E:6). With increase in CT grade, above mentionr:d clinical parameters were similarly increased When clinical and CT criteria were compared simultaneously, of 39 patients with mild by rlinical rriteria 24 patients were in mild (grade A or B) and remaining 15 patients in moderate (grade C or D) by CT criteria. In 10 clinically moderate patients, 5 were in mild (grade A or B), 3 in rnoderate (grade C or K)) and 2 in severe' (grade E1 by CT critqria. In 6 cIimcally severe patient, were in moderate (grade C or D) and 4 were in severe (grade E) by CT criteria. In conclusion, Ranson's clinical criteria and CT grading were both useful in assessing the clinical course oi acute pancreatitiis. Signaficant statistical correlation was not found between two criteria hut combined prognostic criteria may be more helpful in determination of final outcome of acute pancreatitis.
체외 충격파 쇄석술 및 내시경적 유두 괄약근 절개술로 제거된 총담관 거대 담석 2예
민영일(Young Il Min),이영상(Young Sang Lee),김해련(Hae Ryun Kim),김명환(Myung Hwan Kim),정영화(Young Hwa Joung),민병철(Pyung Chul Min),양석균(Suk Kyun Yang),임채만(Chai Man Lim),이승규(Sung Kyu Lee),조경석(Kyung Shik Cho) 대한소화기학회 1990 대한소화기학회지 Vol.22 No.3
We have performed extracorporeal shock-wave lithotripsy for fragmentation in the two patients with 3 cm sized single common bile duct stone, who had been cholecystectomized previously. After ESWL, multiple stone fragments were completely removed by endoscopic papillotomy and balloon extraction.
확대간엽 및 문맥합병절제를 시행한 간문부 담관암의 치료
민영일(Young Il Min),이영상(Yung Sang Lee),김명환(Myung Hwan Kim),이승규(Sung Gyu Lee),민병철(Pyung Chul Min),이문규(Moon Gyu Lee),최건무(Kun Moo Choi),이성구(Sung Goo Lee),성규보(Gyu Bo Sung),오영호(Young Ho Oh) 대한소화기학회 1993 대한소화기학회지 Vol.25 No.5
Although carcinoma of hepatic hilus is generally a slow-growing tumor, the results of treatment continue to be poor, mainly, because of the low resectability rates. A case of resected carcinoma of hepatic hilus with portal vein bifurcation and proper hepatic artery invasion is presented. Preoperatively 3 seperate percutaneous transhepatic biliary drainage was made to right anterior, right posterior segment and left lobe of the liver to control cholangitis and alleviate jaundice. Curative surgery, which included extended right hepatic lobectomy with total caudate lobectomy, and combined resection of hepatoduodenal ligament and regional lymphatic tissue was performed, while an autogenous external iliac vein was interposed between root of portal vein trunk and umbilical portion of left portal vein. The use of hepatectomy with combined resection of portal vein and/or hepatic artery using vascular reconstruction allows curative surgery in the treatment of advanced carcinoma of the hepatic hilus which was previously thought to be inoperable
민영일(Young Il Min),이영상(Young Sang Lee),김해련(Hae Ryun Kim),김명환(Myung Hwan Kim),두영철(Young Cheoul Doo),김상위(Sang We Kim),정영화(Young Hwa Joung),이승규(Sung Gyu Lee),박건춘(Kun Choon Park),민병철(Pyung Chul Min),유은실(Eu 대한소화기학회 1990 대한소화기학회지 Vol.22 No.2
We experienced 2 cases of angiodysplasia in duodenal bulb and stomach. The patients had a history of repeated upper gastrointestinal bleeding, and were diagnosed as a angiodysplasia by gastroscopy and angiography. they were treated with surgery due to large lesional involement.
민영일(Young Il Min),이영상(Young Sang Lee),김명환(Myung Hwan Kim),이승규(Sung Gyu Lee),민병철(Pyung Chul Min),유은실(Eun Sil Yu),정영화(Yong Hwa Chung),오용호(Young Ho Oh) 대한소화기학회 1993 대한소화기학회지 Vol.25 No.5
Hepatocellular carcinoma arising in the caudate lobe is rare and its prognosis is generally poor. Most of lesions already show multiple metastases and are inoperable at the time of presentation, because tumor cells may spread readily through its short portal and hepatic vein branches into the main portal vein and the inferior vena cava early in the disease. We report a case of hepatocellular carcinoma arising in the caudate lobe which was successfully resected through the combined upper midline incision and median sternotomy 43 months ago
민영일(Young Il Min),김명환(Myung Hwan Kim),이승규(Sung Gyu Lee),민병철(Pyung Chul Min),최건무(Kun Moo Choi),이성구(Sung Goo Lee),한덕종(Duk Jong Han),이선영(Sun Young Lee) 대한소화기학회 1993 대한소화기학회지 Vol.25 No.6
N/A Cystic neoplasm of the pancreas is a rare disease accounting for less than 10% to 13% of pancreatic cysts and 1% of patcreatic cancers. It is important to recognize the nature of these tumors for several reasons: they are potenially malignant except serous cystadenoma; gross inspection and even biopsy of the cyst wall can be misleading for distinguishing pseudocysts from neoplasm, serous from mucinous, and benign from malignant; they are readily removable and cure is frequently expected even after resection of cystadenocarcinoma. During the 3-year period, we treated 10 patients (8 women, 2 men: mean age 45 yrs) with cystic neoplasm of the pancreas, including 2 serous cystic adenoma, 4 benign mucinous cystic neoplasms, 1 mucinous cystadenocarcinoma, 2 papillary and solid cystic tumor and 1 mucinous ductal ectasia. Mean tumor size was 8.6 cm (1.5 to 16 cm) and 1 of 10 tumors was malingant. Computed tomography was useful for detection, but was not reliable for distinguishing benign from malignant. Endoscopic pancreatography showed no communication with the cystic cavity in 2 of 2 cases of cystic neoplasms but opacified the ectatic ducts in l of 1 case of mucinous ductal ectasia. The tumor was resected by distal pancreatectomy in 7 patients, by proximal resection in 3 with no operative deaths. While asymptomatic serous cystadenoma can be observed safely, in practice it. is difficult to determine with certainty that a given lesion is a serous cystadenoma and not one of the other, premalignant or malignant varieties. We suggest that cystic tumors of the pancreas should, in general, be resected for the relief of symptoms and for treatment of cancer, when given the low risk of resection