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간세포암종 환자에서 고주파 열치료술 후에 발생한 담관-십이지장 누공 1예
박성길 ( Seong Gill Park ),박성재 ( Sung Jae Park ),구호석 ( Ho Suk Koo ),박상원 ( Sang Won Park ),박은택 ( Eun Tack Park ),이연재 ( Youn Jae Lee ),이상혁 ( Sang Hyuk Lee ),설상영 ( Sang Young Seol ) 대한소화기학회 2008 대한소화기학회지 Vol.51 No.3
Hepatocellular carcinoma (HCC) is one of the most common malignant neoplasms occuring worldwide. Surgical resection currently provides the best chance of long-term tumor free survival, but the most HCCs are not candidates for surgical excision due to poor liver function or poor medical background. Numerous noninvasive alternatives to surgical resection have been introduced to treat liver cancers. Radiofrequency thermal ablation has begun to receive much attention as an effective and minimally invasive technique for the local control of HCC. The biliary system related complications after radiofrequency ablation has rarely been reported. We report a case of biliary-duodenal fistula with liver abscess after radiofrequency ablation for HCC. The case was treated by abscess drainage and antibiotics. (Korean J Gastroenterol 2008;51:199-203)
조현근(Hyeon Geun Cho),정준표(Jun Pyo Chung),박효진(Hyo Jin Pack),윤영원(Young Won Yoon),신은택(Eun Tack Shin),전재윤(Chae Youn Chon),박인서(In Suh Park),김기황(Ki Whang Kim) 대한소화기학회 1994 대한소화기학회지 Vol.26 No.6
The term Biloma was introduced by Gould and Patel to describe encapsulated extrahepatic collections of bile in 1979, and has subsequently been expanded to include intra- hepatic bile collections. Various imaging modalities have been utilized to identify bilomas, in- cluding computerized tomography, ultrasonography, magnetic resonance imaging and radionucleotide studies. Needle aspiration is essential to confirm the diagnosis. Most of biloma resulted from biliary ductal disruption due to abdominal surgery or trauma. Less frequently bilomas have also been reported in association with hepatoma, gall bladder cancer and bile duct pathology. Recently we experienced a case of biloma developed spontanceously in a pa- tient with pancreatic cancer presenting as acute pancreatitis and report with a review of liter- atures.(Korean J Gastroenterol 1994; 26: 1053 1057)
송진호,이상혁,정정명,이연재,장윤식,설상영,박은택 대한소화기내시경학회 1997 Clinical Endoscopy Vol.17 No.5
Background/Aims: Choledochal cyst is an unusual but serious condition which most commonly affects Oriental people. And it is an unusual entity that has increasingly been encountered by ultrasonography and computed tomography scan, even if the symptoms are variable. Methods: We reviewed 23 patients with choledochal cyst who were treated at the Department of Internal Medicine, Pusan Paik Hospital from April, 1986 to April 1995. Results: 1) Age ranged from 14 years to 73 years, and sex ratio was 1:1.4 in male vs female. 2) The durations of symptoms varied from 4 days to several years. 3) The major clinical symptoms were right upper quardrant pain in 19 cases, jaundice in 4 cases, abdominal mass in 2 cases. One case had all of above three symptoms. 4) The diagnostic tools were ultrasonography(USG) in l7 cases, ERCP in 11 cases, abdominal CT in 11 cases, PTC in 6 cases and oral GB in ~1 case. The eight cases(61.5%) were confirmed as anomalous junction of the pancreaticobiliary ductal system(AJPBS) among the 13 cases who had performed ERCP. 5) The choledochal cysts were classified into type I to V according to the classification of Todani; Fifteen cases were type I, six cases type IVa, one case was type II and one case was type V, respectively. 6) Excision of choledochal cyst and Roux-en-Y hepaticojejunostomy was performed in 10 cases, and choledocho-jejunostomy in 4 cases, and Whipple's operation in 2 cases. 7) The associated diseases were CBD stone in 8 cases, cholecystitis in 6 cases, intrahepatic stone in 2 cases, GB cancer in 1 case, and colon cancer in 1 case. Conclusions: ERCP should be used when choledochal cyst is suspected by USG, aiming at demonstrating both AJPBS and enabling the morphologic classification. In addition, Surgical procedures including the excision of choledochal cyst and Roux-en-Y hepaticojejunostomy may be effective to reduce mortality and morbidity related to complication of choleclochal cyst.