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부식성 상부식도 협착증에서 하인두-장 문합에 의한 식도재건술
박재길,이선희,장윤희,진웅,곽문섭,김세화,천성원,Park, Jae-Kil,Lee, Sun-Hee,Chang, Yun-Hee,Jin, Ung,Kwack, Moon-Sub,Kim, Se-Wha,Chun, Sung-Won 대한흉부심장혈관외과학회 1998 Journal of Chest Surgery (J Chest Surg) Vol.31 No.9
대상 및 방법: 저자들은 1995년 8월부터 1997년 1월까지 상부 식도를 포함한 광범위한 부식성 협착증 환자 7례에서 하인두-결장문합에 의한 식도재건술을 시행하였다. 결과: 연령은 20세에서 63세까지 였으며 7례중 6례가 여성이었다. 부식제는 6례에서 강산이었고 1례는 알칼리 용액이었으며, 부식제 연하후 식도재건까지의 기간은 6개월에서 50년이었다. 식도재건 방법으로 4례에서는 하인두- 우결장-공장문합을 시행하였으며, 3례에서는 하인두-우결장-위문합을 시행하였다. 수술사망례는 없었고 7례중 1례에서 만 문합부 협착으로 수차례의 식도 확장술을 받았으며, 6례에서는 경구섭식에 문제가 없어 전례에서 관찰기간중에 4kg 내지 13kg의 체중증가 소견을 보였다. 결론: 결론적으로 상부식도 협착증에서의 하인두-결장 문합술은 유효하고 안전한 술식이라고 할 수 있다. Material and Method: Esophageal reconstruction by the hypopharyngointestinal anastomosis was done in 7 patients of corrosive upper esophageal stricture at St. Mary's Hospital from August 1995 to January 1997. Result: There were one male and six female patients ranging from 20 to 63 years of age. The causative agents were acid in 6 patients and alkali in 1 patient. The esophageal reconstruction was made by hypopharyngcolojejunostomy in 4 patients and hypopharyngocologastrostomy in 3 patients. There were no operative mortalities. One patient developed anastomotic stenosis but others were free from dysphagia. All gained 4 kg to 13 kg of body weight during the follow-up period. Conclusion: In this experience right colon and terminal ileum including ileocecal valve was revealed as a good substitute for the esophagus and the esophageal reconstruction by hypopharyngocologastro (jejuno)stomy seems to be a satisfactory method with acceptable morbidity and mortality in corrosive upper esophageal stricture patient.
담관 낭종에서 Jejunal Interposition Hepaticoduodenostomy 술식의 임상경험
김동우(Dong Woo Kim),이종서(Jong Seo Lee),천성원(Sung Won Chun),송영택(Young Tack Song) 대한소화기학회 1990 대한소화기학회지 Vol.22 No.1
Choledochal cyst is an uncommon anomaly in Oriental peoples.Hepaticoduodenstomy and Roux-en-Y hepaticojejunostomy for bile duct reconstruction after cyst excision has long been used as the standard procedure for surgical treatment of choledochal cyst. Hepaticoduodenostomy is technically simple and physiological, but it has frequent ascending infection. Roux-en-Y hepaticojejunostomy has less chance for reflux of intestinal contents, but it has increased incidence of peptic ulcer(McArther & Longmire, 1971) and fat malabsorption that may due to diversion of bile flow. The jejunal interposition hepaticoduodenostomy technique(10cm, isoperistaltic sement) after cyst excision was reported by Grassi in 1971, evaluated by longmire et al. in 1978, recommended for the treatment of choledochal cyst by Raffensperger in 1980. Recently, authors experienced this procedure in three cases of chledochal cyst and briefly reviewed with literatures.