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개정된 대한췌장담도학회 급성췌장염 임상진료지침: 개정 목적과 과정
최정완 ( Jung Wan Choe ),이상협 ( Sang Hyub Lee ),천영국 ( Young Koog Cheon ),이홍식 ( Hong Sik Lee ),최미영 ( Miyoung Choi ) 대한췌장담도학회 2022 대한췌담도학회지 Vol.27 No.1
Acute pancreatitis can range from a mild, self-limiting disease that requires no more than supportive care to severe disease with life-threatening complications. Therefore, to provide a framework for clinicians to manage acute pancreatitis and to improve national health care, the Korean Pancreatobiliary Association (KPBA) established the first Korean guideline for the management of acute pancreatitis in 2013. However, many challenging issues exist, which sometimes lead to differences in practice between clinicians. Taking together the recent dramatic changes of latest knowledge and evidence newly obtained, the committee of the KPBA decided to perform an extensive revision of the guidelines. These revised guidelines were developed by using mainly Delphi methods, and the main topics of these guidelines fall under the following topics: 1) diagnosis, 2) severity assessment, 3) initial treatment, nutritional support, and convalescent treatment, 4) the treatment of local complication and necrotizing pancreatitis. The specific recommendations are presented with the quality of evidence and classification of recommendations. Korean J Pancreas Biliary Tract 2022;27(1):1-5
증례 ; 내시경 점막 절제술로 치료한 식도 혈관종: 증례 보고와 문헌고찰
김지혜 ( Ji Hye Kim ),정성우 ( Sung Woo Jung ),송종규 ( Jong Gyu Song ),최정완 ( Jung Wan Choe ),김승영 ( Seoung Young Kim ),현종진 ( Jong Jin Hyun ),정영걸 ( Young Kul Jung ),구자설 ( Ja Seol Koo ),임형준 ( Hyung Joon Yim ),이상 대한소화기학회 2015 대한소화기학회지 Vol.66 No.5
Hemangioma of the esophagus is a rare form of benign esophageal tumor. It usually presents as a single lesion located in the lower third of the esophagus and is mostly asymptomatic. However, it may occasionally cause hematemesis and/or obstruction. Surgical resection is the conventional treatment modality for managing esophageal hemangioma, but less invasive approaches such as endoscopic therapy are recently becoming more widely employed. Herein, we report a case of a 54-year-old man who presented with an esophageal hemangioma that was successfully treated by endoscopic mucosal resection without any complications. (Korean J Gastroenterol 2015;66:277-281)
십이지장경 삽입 중 발생한 식도점막 열상으로 인해 진단된 동시성 식도암과 위암
김동우 ( Dongwoo Kim ),현종진 ( Jong Jin Hyun ),이종진 ( Jong Jin Lee ),최정완 ( Jung Wan Choe ),강규호 ( Kyu Ho Kang ),황수현 ( Su Hyun Hwang ),김대하 ( Dae-ha Kim ) 대한췌담도학회 2018 대한췌담도학회지 Vol.23 No.2
이전에 합병증 없이 내시경 역행성 담췌관 조영술(ERCP)을 여러 번 시행받은 71세 남자 환자에게 내시경 삽입 중 식도점막 파열이 발생하였다. 점막열상은 내시경클립(endoclip)을 사용하여 성공적으로 봉합되었으나, 이 합병증으로 인해 식도암과 조기 위암이우연히 동시에 발견되었다. 십이지장경은 위장관, 특히 식도 관찰에 제약이 있기 때문에 임상적으로 중요한 병변을 놓칠 가능성이 있다. 따라서 점막 손상이나 천공을 예방하기 위해 내시경선단에 충분한 윤활제를 도포하는 것과 함께 ERCP 중 상부내시경 검사를 시행하는 것도 고려되어야 한다. 어느 환자군에서 ERCP 중 상부내시경 검사가 유용할지에 대해서는 향후 대규모 연구가 필요할 것이다. Esophageal mucosal tear occurred during scope insertion in a 71-year-old male patient who previously underwent endoscopic retrograde cholangiopancreatography (ERCP) several times without any complications. The mucosal tear was successfully sealed with endoclips using a forward-viewing scope. However, this mishap leads to the incidental discovery of both esophageal cancer and early gastric cancer. Duodenoscope has inherent limitation in observing the gastrointestinal tract, especially the esophagus, and may miss clinically significant lesions. Therefore, in addition to applying sufficient lubricant to the scope tip and considering the possibility of anatomical variation to prevent mucosal injury or perforation, performing upper endoscopy during ERCP should be considered in a certain patient population, albeit the utility of and the population benefiting from it remains to be proven by a large-scale study.