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Clinical Practice Guidelines for the Endoscopic Management of Peripancreatic Fluid Collections
오치혁,송태준,이준규,박진석,이재민,손준혁,장동기,최미영,변정식,이인석,이수택,최호순,김호각,전훈재,박찬국,조주영 대한췌장담도학회 2022 대한췌담도학회지 Vol.27 No.2
Endoscopic ultrasonography-guided intervention has gradually become a standard treatment for peripancreatic fluid collections (PFCs). However, it is difficult to popularize the procedure in Korea because of restrictions on insurance claims regarding the use of endoscopic accessories, as well as the lack of standardized Korean clinical practice guidelines. The Korean Society of Gastrointestinal Endoscopy (appointed a Task Force to develope medical guidelines by referring to the manual for clinical practice guidelines development prepared by the National Evidence-Based Healthcare Collaborating Agency. Previous studies on PFCs were searched, and certain studies were selected with the help of experts. Then, a set of key questions was selected, and treatment guidelines were systematically reviewed. Answers to these questions and recommendations were selected via peer review. This guideline discusses endoscopic management of PFCs and makes recommendations on indication for the procedure, pre-procedural preparations, optimal approach for drainage, procedural considerations (e.g., types of stent, advantages and disadvantages of plastic and metal stents, and accessories), adverse events of endoscopic intervention, and procedural quality issues. This guideline was reviewed by external experts and suggests best practices recommended based on the evidence available at the time of preparation. This will be revised as necessary to address advances and changes in technology and evidence obtained in clinical practice and future studies.
오치혁 ( Chi Hyuk Oh ),동석호 ( Seok Ho Dong ) 대한소화기학회 2015 대한소화기학회지 Vol.66 No.5
Approximately 3-15% of patients who have undergone removal of bile duct stones with endoscopic sphincterotomy have recurrence of stones which often presents as acute cholangitis. Despite better understanding on the factors and mechanisms underlying the recurrence of bile duct stones achieved during the past few decades, endoscopic removal still remains the mainstay of management for recurrent bile duct stones. Recently investigated and suggested management of recurrent bile duct stones are highlighted in this review. (Korean J Gastroenterol 2015;66:251-254)
증례 : 순화기 ; 건강한 성인에서 인플루엔자 A (H1N1)에 감염에 의해 발생한 급성 심장막염 1예
오치혁 ( Chi Hyuk Oh ),김진배 ( Jin Bae Kim ),김유진 ( Yu Jin Kim ),이태인 ( Taein Lee ),변종규 ( Jong Kyu Byun ),김권삼 ( Kwon Sam Kim ),김우식 ( Woo Shik Kim ) 대한내과학회 2014 대한내과학회지 Vol.87 No.4
A 21.year.old male with no any other diseases presented with fever, chills, and chest discomfort. A chest radiography scan and transthoracic echocardiogram revealed a large amount of pericardial effusion. An H1N1 viral real.time PCR test confirmed the presence of H1N1 viral infection. Pericardiocentesis was performed to reduce symptoms, and oseltamivir (Tamiflu TM ) was administered. His symptoms improved during the first 4 days, and there was no relapse of the pericardial effusion. The most common manifestation of influenza A infection is respiratory tract infection. Although a cardiovascular manifestation is possible, it is extremely rare. We have reported here a case of acute pericarditis with a large amount of pericardial effusion in a healthy adult infected with influenza A virus (H1N1, swine.origin). (Korean J Med 2014;87:461-465)
2개의 서로 다른 부전도로를 가진 비후성 심근병증 환자를 전극도자 절제술로 치료한 증례
오치혁 ( Chi Hyuk Oh ),김승민 ( Seung Min Kim ),신재령 ( Jae Ryung Shin ),유정선 ( Jung Sun Yoo ),윤경한 ( Kyung Han Yoon ),김진숙 ( Jin Sug Kim ),박지윤 ( Ji Yoon Park ),김슬기 ( Seul Ki Kim ),김진배 ( Jin Bae Kim ) 전북대학교 의과학연구소 2013 全北醫大論文集 Vol.37 No.1
A 41-year-old man, with WPW syndrome and a hypertrophic cardiomyopathy, was admitted for recurrent palpitation. EPS (Electrophysiological study) identified that manifested bypass tract was an innocent bystander, and another concealed bypass tract was utilized as retrograde conduction, during AVRT (atrioventricular reentrant tachycardia). The multiple accessory pathways could be localized at the right free wall and left posteroseptal area. Both of them were successfully abolished with catheter ablation. Successful catheter ablation provides an evident risk reduction, as a result of a lower incidence of AF(atrial fibrillation) and a complete removal of risk for ventricular tachyarrhythmia.
스파이글래스, 담도경 및 일시적 담도배액관 삽입을 통한 난치성 담석의 치료
오치혁 ( Chi Hyuk Oh ) 대한췌장담도학회 2020 대한췌담도학회지 Vol.25 No.1
대부분의 담관결석은 내시경역행담췌관조영술(endoscopic retrograde cholangiopancreatography, ERCP)을 통해서 제거가 가능하다. 하지만 약 10% 내외의 경우에서는 ERCP를 이용한 전통적인 방법으로 제거가 어려운 경우가 있기 때문에 이를 극복하는 여러 방법에 대해서 알아두고 숙지하는 것이 필요하다. 본고에서는 SpyGlass를 이용한 단일시술자 담도 내시경, 직접 경구 담도 내시경 및 일시적인 담관 스텐트 삽입법을 통해서 난치성 담석을 제거하는 방법에 대해서 소개하고자 한다. At least 90% of stones are extracted after conventional endoscopic retrograde cholangiopancreatography. However, some cases are still difficult to manage completely. We describe some methods of removing difficult common bile duct stones through a single-operator cholangioscopy using SpyGlass system, direct peroral cholangioscopy, and temporary biliary stenting.
신정하,오치혁,동석호 대한소화기학회 2022 대한소화기학회지 Vol.80 No.4
ERCP is the standard treatment for common bile duct stones (CBD stones). On the other hand, in approximately 10% of patients with CBD stones, the complete removal of the stones cannot be achieved by conventional ERCP, which performs endoscopic sphincterotomy followed by stone extraction. Additional advanced and complex procedures are often necessary to remove these “difficult bile duct stones”, including endoscopic papillary large balloon dilatation or mechanical lithotripsy. Advances in cholangioscopy have made electrohydraulic or laser lithotripsy under direct endoscopic visualization possible during ERCP. Cholangioscopy-guided lithotripsy using the SpyGlass DS system could be a better treatment tool for removing difficult stones. The focus of this review was to describe single-operator cholangioscopy in the management of difficult CBD stones.
김영롱,오치혁,양민재 대한췌장담도학회 2023 대한췌담도학회지 Vol.28 No.1
Gallbladder cancer is the most common cause of hilar biliary obstruction; however, it rarely causes combined biliary, duodenal, and colon triple obstruction. In this case, the quality of life for a patient with recurrent gallbladder cancer with combined duodenal, colonic, and biliary obstruction was improved by endoscopic and endosonographic palliation, despite its technical difficulty and complexity. Seven metal stents were implanted one by one using only endoscopic methods. Successful stent-in-stent placement and endoscopic ultrasound-guided stenting after failed ERCP improved the patient’s quality of life to the extent that there was no need for any external drainage.