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지속적 외래 복막 투석을 위한 도관 삽입술 및 도관 관련 합병증에 대한 연구
곽정면(Jung Myun Kwak),정석인(Suk In Jung),민연기(Youn Ki Min),강석형(Seok Hyung Kang),조용걸(Yong Geul Joh),조민영(Min Young Cho),송태진(Tae Jin Song),이재복(Jae Bok Lee),배정원(Jeoung Won Bae),서성옥(Sung Ok Suh),김영철(Young Chul 대한외과학회 2002 Annals of Surgical Treatment and Research(ASRT) Vol.62 No.2
황정웅,서성옥,김세민 대한소화기내시경학회 1993 Clinical Endoscopy Vol.13 No.4
Surgical advance on the general surgical department as minimal access procedure was changed into the laparoscopic cholecystectomy from open cholecystectomy for treatment of cholelithiasis. Laparoscopic cholecystectomy is far less invasive, less painful, less expensive, less complicative, high cosmetic and high conservative procedure, and reduced hospitalization than open surgery. The retrospective study of 176 patients undergoing laparoscopic cholecystectomy during 16 months from September 1991 through December 1992 was conducted. We evaluated the diagnostic tools, previous operation history, associated disorders, operation time, postoperative condition, lyospitalization days, gallbladder pathology, conversion rate to open cholecystectomy and complications. The results were as follows; 1) Of 176 patients who were taken the laparoscopic cholecystectomy, patients' age ranged from 14 to 87 years and female patient were 119 cases(67.8%) and symptomatic cases were 114 cases(65%). 2) Diagnostic tools were abdominal sonogram(100%) in all cases and oral cholecystogram 88 cases(88%), retrograde cholangiopancreaticography 62 cases(38%) and HIDA or abdominal computerized tomography in 4 cases(2%). 3) The most common previous operation history was OB & GY surgery. 4) The common associated disorders were the heart diseases(26.7%), COPD and diabetes(both 16%), and liver cirrhosis(14.7%). 5) Of the 176 gallbladder pathology, 165 cases(93.8%) were contained cholelithiasis, chronic cholecystitis in 139 cases(84.3%), acute cholecystitis in 26 cases(15.7%), GB polyp in 8 cases(4.5%) and cancer in 3 cases(1.7%). 6) Ten cases of the 176 laparoscopic cholecystectomy(5.7%) were required conversion to open cholecystectomy. And average operation time was 65 minutes, total success rate was 94.3%, and there was no death. 7) The complication rate was 6.3%, and wound pain, prolonged ileus and bleeding were noted in decreasing order of frequency. 8) The average postoperative stay was 3.2 days. In conclusion, laparoscopic cholecystectomy which was taken for the symptomatic cholelithiasis will be offered as the most effective therapeutic modality.
내시경적 유두 괄약근 절개술 후 복강경 담낭 절제술의 효과
김영철,최상용,최원준,김창덕,정기훈,송태진,서성옥,채기봉 대한소화기내시경학회 1998 Clinical Endoscopy Vol.18 No.3
Background/Aims: There are some options which exist in the optimal treatment of Common Bile Duct (CBD) stones. The management of CBD stones by a preoperative Endoscopic Sphincterotomy (EST) and a Laparoscopic Cholecystectomy (LC) remains controveraial. This study intends to investigate the value of an EST before an LC in patients with CBD stones compared with a conventional Open Cholecystectomy (OC) with a Common Bile Duct Exploration (CBDE). Methods: Sixty three patients underwent an EST before an LC, while 65 patients received an OC with a CBDE were reviewed retrospectively for a 42 month period from January, 1993 to June, 1996. Results: There was no statistical significance of stone numbers and sizes in both groups (p$gt;0.05), but the EST before the LC group a showed a shorter hospital stay (12.2 days:19.8 days, p $lt; 0.05). The complication rate in conventional OC with the CBDE group was greater but it was not statistically significant(p$gt;0.05). Rate of stone recurrence and remnant stones in the OC with CBDE group (50.8%) was ater than the EST before LC group (25.4%)(p $lt;0.05). The total hospitalization fee in the EST before LC group was lesser than the OC with CBDE group (p$lt;0.05). Conclusions: An EST before an LC is a valuable option for patients with gall stones and simultaneous choledocholithiasis and is suitable according to recent trends in the minimal invasive approach. It needs however, larger group evaluation in order to determine the accurate indications and proper patient selection for this procedure.