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Imaging Spectrum after Pancreas Transplantation with Enteric Drainage
Jian-Ling Chen,Rheun-Chuan Lee,Yi-Ming Shyr,Sing-E Wang,Hsiuo-Shan Tseng,Hsin-Kai Wang,Shan-Su Huang,Cheng-Yen Chang 대한영상의학회 2014 Korean Journal of Radiology Vol.15 No.1
Since the introduction of pancreas transplantation more than 40 years ago, surgical techniques and immunosuppressive regiments have improved and both have contributed to increase the number and success rate of this procedure. However, graft survival corresponds to early diagnosis of organ-related complications. Thus, knowledge of the transplantation procedure and postoperative image anatomy are basic requirements for radiologists. In this article, we demonstrate the imaging spectrum of pancreas transplantation with enteric exocrine drainage.
Polypoid Lesions of the Gallbladder: A Long-Term Follow-Up of 1204 Patients
( Shu-cheng Chou ),( Shin-e Wang ),( Shih-chin Chen ),( Yi-ming Shyr ) 대한간학회 2017 춘·추계 학술대회 (KASL) Vol.2017 No.1
Aims: Polypoid lesions of the gallbladder (PLG) are common, and most of them are benign. Few lesions are found malignant, but cannot be distinguished preoperatively by using common image modalities. Therefore, we compared characteristics of benign and malignant PLGs. Methods: We enrolled 1204 consecutive patients diagnosed with PLG at Taipei Veterans General Hospital during January 2004 to December 2013. Patients underwent either surgery or regular follow-up with various imaging modalities for at least 24 months. The mean follow-up duration was 72 ± 32 months. Results: Amoung our 1204 patients, 194 underwent surgical treatment and 1010 underwent regular follow-up. In addition, 73% patients were asymptomatic. The mean PLG size was 6.9 ± 7.7 (range, 0.8-129) mm; the PLGs of 337 patients (28%) grew during their follow-up periods. The majority of PLGs (90.4%) were single lesions, and 10.5% of patients had associated gallstones. The PLGs of 20.1% of surgical patients were malignant. Malignant PLGs were found in 32.4% of patients ≥50 years old and in 4.7% of those <50 years old (p < 0.001). Right quadrant abdominal pain, epigastric pain, and body weight loss were the three most common symptoms associated with malignancy. Malignant PLGs were significantly larger than benign lesions (means: 27.5 ± 18.4 mm vs. 12.3 ± 12.3 mm respectively, p < 0.001). Notably, the size of 5% of malignant PLGs was 3-5 mm, and that of 8% was 5-10 mm. The negative predictive value for gallbladder malignancy was 92.8% based on a size ≥10 mm and 100% based on a size ≥3 mm. Conclusions: Our study reassesses the PLG size that warrants more aggressive intervention. Cholecystectomy remains mandatory for PLGs >10 mm, but should also be considered a definitive diagnostic and treatment modality for PLGs with diameters of 3-10 mm.