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증례 : 외과적 클립의 이동으로 초래된 총담관 폐색 1예
권영우 ( Young Woo Kwon ),허병원 ( Byung Won Hur ),오웅식 ( Woong Sik Oh ),이정환 ( Jung Hwan Lee ),김해경 ( Hae Kyung Kim ),박성우 ( Sung Woo Park ),류성태 ( Seong Tae Ryu ) 대한내과학회 2005 대한내과학회지 Vol.69 No.-
복강경 담낭 절제술은 담낭 결석 및 용종 등의 담낭 질환의 치료법으로 널리 이용되고 있다. 드물게 이 수술의 합병증으로 클립의 총담관, 십이지장 및 폐동맥으로 이동이 보고되고 있다. 복강경 담낭 절제술 후 복통, 황달, 발열, 오심, 구토 등의 담관염 증세가 있으며, 추적 단순 방사선 소견에서 우상복부에 존재하는 클립의 위치 변화가 있을때, 클립의 이동에 의한 총담관 폐색을 의심해 보아야 한다. 저자들은 내원 7개월 전 복강경 담낭 절제술을 시행받았던 환자에서 외과적 클립의 이동으로 초래된 총담관 부분 폐색을 내시경적 역행성 담관조영술로 진단하고 제거하였기에 이를 문헌고찰과 함께 보고하는 바이다. The laparoscopic cholecystectomy, which was originally developed in Europe, is now gaining wide acceptance due to a less painful surgery, a shortened hospital stay and less scarring. But the laparoscopic cholecystectomy were reported serious complications such as, gallbladder bed hemorrhage, bile duct injury, jejunal perforation and rarely dislocation and migration of the surgical clips. We report a 61-year-old man with obstructive jaundice that was generated surgical clips migration into the common bile duct, who had undergone a laparoscopic cholecystectomy because of acute calculous cholecystitis 7 months ago. Abdominal CT scan revealed multiple clips into the distal CBD and mild dilatation of intrahepatic biliary tree. The clips were removed using basket after endoscopic sphincterotomy. (Korean J Med 69:S772-S776, 2005)
2형 당뇨 환자에 있어서 C형 간염의 유병률에 관한 연구
김구영,서광섭,유광렬,임병욱,채선애,강남훈,김창훈,권영우,김희수,류성태,이정환,박성우,오웅식,김정한 중앙대학교 의과대학 의과학연구소 2003 中央醫大誌 Vol.28 No.1
Background: We have doubt about the truth that Type 2 DM is associated with chronic hepatitis C infection. The aim of our study was to prove a close relationship between chronic HCV infection and type 2 DM in korean patients. Methods: We reviewed the out-patient's medical records of 466 patients with type 2 DM who visit the Sung-ae hospital from March 2000 to August 2001. Diabetic patients were analyzed for the following variables: age, sex, waist circumference, weight, waist/hip ratio, using of self monitoring of blood glucose, method of therapy, duration of disease, experience of previous transfusion, major surgical procedure, accompanied disease, liver function tests (LFT), HbA1 c. We ruled out patients with liver cirrhosis. Results: Hepatitis C virus infection was observed more frequently in patient with Type 2 DM. Of 466 Type 2 DM patients, 13 patients were infected with Hepatitis C virus (2.79%). Compared with mean prevalence of Korean population (1.3~1.6%), it's value is very high. the other hand, 21 patients were infected with Hepatitis B virus (4.5%). Such results are similar to mean prevalence of the general public (4~5%). Conclusions: Prevalence of hepatitis C was closely associated in korean patients with type 2 DM. And an increased prevalence is independent of cirrhosis.