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위십이지장 동맥에서 분지한 우간동맥 압박에 의한 담관석을 동반한 폐쇄 황달
백양현 ( Yang Hyun Baek ),최석렬 ( Suk Ryul Choi ),이종훈 ( Jong Hun Lee ),김민지 ( Min Ji Kim ),김영훈 ( Young Hoon Kim ),노영훈 ( Young Hoon Roh ),노명환 ( Myung Hwan Roh ) 대한소화기학회 2008 대한소화기학회지 Vol.52 No.6
Obstructive jaundice by vascular compression is rare. The causative arteries were identified as the right hepatic artery, gastroduodenal artery, cystic artery, proper hepatic artery, and an unspecified branch of the common hepatic artery. Also the venous system, such as enlarging collateral veins in cases of portal hypertension was a causative vessel. Herein, we describe a case of a proximal choledocholithiasis due to compression of the common bile duct by right hepatic artery originated from gastroduodenal artery. Final diagnosis and treatment were achieved through an operation.
Propofol 과 Fentanyl 로 상부 위장관 내시경시 산소 공급에 따른 산소 포화도에 관한 연구
이종훈,박한석,한상영,신우원,노명환,최대현,오일환,문성훈,최석렬 대한소화기내시경학회 2001 Clinical Endoscopy Vol.22 No.6
Background/Aims: Propofol is usually used for anesthesia in the case of day surgery. We studied the effects of propofol plus fentanyl for sedation and the effect of oxygenation during gastroscopy, Methods: 154 patients who asked conscious sedation during gastroscopy were randomly divided into three groups. The first group (PF-0 group, 50 patients) and the second group (PF group, 48 patients) were received an initial bolus dose of propofol (40 mg) plus fentanyl (50 ㎍) intravenously, followed by additional doses of propofol at one minute interval until conscious sedation. PF-0 group was received preoxygenation (3 L/min) via nasal canula, and PF group was not, The third group (56 patients) received an initial bolus dose of midazolam (3 mg) intravenously, followed by additional doses of midazolam at two minutes interval (M group). Results: In PF-0 group, time to achieve sedation, regain orientation, and recover walking ability were 118.0±85.2 sec, 67.5±91.2 sec and 11.1±5.3 min. Gag reflex during the procedurs absent or nearly absent in 96% of patients. Despite the changes of blood pressure and heart rate compared to the values taken prior to the procedures were observed, all values were not clinically significant, In PF-0 group, transient oxygen desaturation (SaO2$lt;90%) was observed in four (8.0%) patients. Conclusions: Propofol plus fentanyl with oxygenation seems to be more acceptable and suitable method for sedation during outpatient gastroscopic examination.