http://chineseinput.net/에서 pinyin(병음)방식으로 중국어를 변환할 수 있습니다.
변환된 중국어를 복사하여 사용하시면 됩니다.
문현종 ( Hyoun Jong Moon ),노상익 ( Sang Ik Noh ),허진석 ( Jin Seok Heo ),최성호 ( Seong Ho Choi ),조재원 ( Jae Won Joh ),김용일 ( Yong Il Kim ) 대한소화기학회 2003 대한소화기학회지 Vol.41 No.5
Background/Aims: Mortality following pancreatoduodenectomy has decreased markedly. However, complication rate after pancreatoduodenectomy is still 30-40%. Especially, hemorrhage is the most common cause of mortality. Methods: From Oct. 1994 to May. 2002, pancreatoduodenectomy was preformed in 454 patients at Samsung Medical Center. The medical records of these patients were reviewed. Results: There were 35 cases of hemorrhage. Among them, 14 cases showed early bleeding within 5 days after operation and 21 cases showed late hemorrhage. In cases of early hemorrhage, type of pancreatoduodenectomy is a critical factor (p=0.040), while in cases of late hemorrhage, the existence of malignancy (p=0.035) and history of intraabdominal complications (p=0.017) are critical factors. Moreover, 17 cases (48.8%) of them were from peripancreatic arteries and 9 cases (25.7%) were from anastomotic site. In 14 cases (40%), operative treatment was carried out firstly and in 10 cases (28.6%), transarterial embolization was selected as a main treatment modality. There were 8 cases of pseudoaneurismal hemorrhage and 3 cases (8.6%) of death. Conclusions: Hemorrhage after pancreatoduodenectomy is a serious problem resulting in high mortality rate. For prevention and effective treatment of hemorrhagic complications, more meticulous bleeding control during operation and close care after operation are needed. Additionally, intraabdominal local inflammation should be considered as a factor to cause massive late hemorrhage. (Korean J Gastroenterol 2003;41:398-405)
김민권(Min-Ghwon Kim),이호석(Ho-Suk Lee),박창균(Chang-Kyun Park),조유진(Yoo-Jin Cho),황덕원(Duk Won Hwang),노상익(Sang-Ik Noh) 대한외과학회 2007 Annals of Surgical Treatment and Research(ASRT) Vol.73 No.5
Purpose: The purpose of this study is to assess the periopertive morbidity and mortality rates in relation to the principal variables in aged patients who undergo laparoscopic colorectal resection. Methods: From March 2001 to March 2006, the prospective laparoscopic colorectal resection database was used to identify 233 patients. Among them, 132 were 70 years of age or older and they were classified as the aged group. 101 were younger than 70 years of age and they were classified as the younger group. Results: Comorbidity was more common in the aged group than in the younger group (67.4% and 53.5%, respectively) (P=0.030). There were higher ASA scores in the aged group (Ⅰ: 2.3% Ⅱ: 68.2% Ⅲ: 29.5%) than in the younger group (Ⅰ: 27.7% II: 56.4% Ⅲ: 15.8%) (P<0.0001). There was a higher postoperative complication rate for the aged group than for the younger group (25.0% and 8.9%, respectively) (P=0.002). Only one case of mortality (0.8%) was found in the aged group. The period of the postoperative hospital stay was longer for the aged group than that for the younger group (21.9±3/416.3 days and 16.3±3/48.1days, respectively) (P=0.002). For the aged group, univariate analysis revealed that the operative procedure, disease, the T stage and the operation time were significant variables for the postoperative complications, and multivariate analysis identified the operation time as an independent variable faor the postoperative complications. Conclusion: More prudent care is needed to prevent postoperative complications for the aged patients who undergo laparoscopic colorectal resection, and particularly for those who can be expected to have a longer operation time.