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Byeong Gwan Noh,박영목,Jung Bum Choi,Byoung Chul Lee,Sang Su Lee,Hyuk Jae Jung 대한혈관외과학회 2020 Vascular Specialist International Vol.36 No.4
Purpose: The number of infrapopliteal runoff vessels seems to be one of the factorsinfluencing arterial patency in patients who had undergone superficial femoralartery (SFA) angioplasty with stenting. However, the effectiveness of infrapoplitealrunoff vessels in predicting patency during SFA angioplasty remains unclear. Thisstudy aimed to determine whether the number and quality of infrapopliteal runoffvessels affect the primary patency after SFA angioplasty with stenting in patientswith claudication. Materials and Methods: This study reviewed a retrospective database of patientswith claudication who underwent SFA angioplasty with stenting between March2011 and December 2016. The preoperative computed tomography findings of allpatients were reviewed to assess infrapopliteal runoff vessels. The Trans-AtlanticInter-Society (TASC) II classification and modified Society for Vascular Surgery (SVS)runoff score were used for subsequent analysis. Kaplan–Meier survival curves wereconstructed, and Fisher’s exact and chi-square tests were used for data analysis. Results: A total of 153 limbs of 122 patients (88.2% male, mean age: 69.1 years)underwent SFA angioplasty with stenting. The overall primary patency rates ofTASC II A/B and C/D cases were 77.1% and 31.2%, respectively, at 36 months(P<0.001). The primary patency rates at 36 months using the modified SVS runoffscoring system were 64.6% and 49.8% for the good-to-compromised (≤9 points)and poor (≥10 points) runoff groups, respectively (P=0.011). Conclusion: The modified SVS runoff scoring system is effective in predicting primarypatency after SFA angioplasty with stenting in patients treated for claudication.
Clinical impact of serum prealbumin in pancreaticobiliary disease
박영목,서형일,Byeong Gwan Noh,Suk Kim,Seung Baek Hong,이남경,김동욱,한성용 대한종양외과학회 2022 Korean Journal of Clinical Oncology Vol.18 No.2
Purpose: Although there are many studies on prealbumin in individual diseases such as malignant or inflammatory diseases, there are few comparative studies. This study aimed to compare the clinical differences between prealbumin levels in cholecystitis and pancreaticobiliary malignancies and investigate the clinical impact of low prealbumin levels in pancreaticobiliary malignancies. Methods: From June 2021 to September 2021, 61 patients who had undergone surgery for various pancreaticobiliary diseases were enrolled in this study, and their clinicopathological data were retrospectively analyzed. Results: Many elderly patients with malignant diseases had poor American Society of Anesthesiologists (ASA) scores, significantly lower albumin and prealbumin levels, and higher systemic immune inflammation indices. The low prealbumin group was older; had poorer ASA scores; and had significantly lower body mass index and hemoglobin and albumin levels and higher systemic immune inflammation indices than the normal prealbumin group. In malignant diseases, the low prealbumin group had significantly lower body mass index and hemoglobin levels and a tendency toward more advanced disease (lymph node and distant metastasis). Conclusion: Preoperative low prealbumin levels had an area under the receiver operator characteristic curve of 0.69, suggesting that it may be useful for predicting pancreaticobiliary malignancies. Prealbumin levels were lower in malignant diseases, possibly related to poor nutritional status and systemic immune inflammation. Low prealbumin levels may predict the risk of more advanced disease.
Young Mok Park,Hyung Il Seo,Byeong Gwan Noh,Suk Kim,Seung Baek Hong,Nam Kyung Lee,Dong Uk Kim,Sung Yong Han 한국간담췌외과학회 2023 Annals of hepato-biliary-pancreatic surgery Vol.27 No.4
Backgrounds/Aims: In 2019, the grading and staging system for neuroendocrine neoplasms (NENs) was significantly changed. In this study, we report the clinicopathological characteristics and surgical outcomes of patients with extrahepatic biliary NENs who underwent curative resection with or without adjuvant treatment. Methods: We retrospectively reviewed a database of 16 patients who developed NENs, neuroendocrine carcinoma (NEC), and mixed endocrine non-endocrine neoplasms (MiNENs) after curative resection. Among them, eight patients had ampulla of Vater (AoV) tumors, and eight patients had non-AoV tumors. Results: G1 and G2 were more frequently observed in the AoV group than in the non-AoV group (12.5% and 62.5%, respectively). In contrast, NEC and MiNEN were more common in the non-AoV group (50.0%). High Ki-67 index (> 20%) and perineural invasion (PNI) were more frequently observed in the non-AoV group. Advanced age (> 65 years), mitotic count > 20 per 2 mm2, and Ki-67 index > 20% were strongly correlated with patient survival (p = 0.018, 0.009, and 0.044, respectively). Advanced age (> 65 years) and mitotic count > 20 per 2 mm2 were significantly correlated with disease recurrence (p = 0.033 and 0.010, respectively). Conclusions: AoV and non-AoV tumors had significant differences in the histologic grade, Ki67, and PNI. Patients with non-AoV tumors had an increased risk for survival and recurrence than those in the AoV group. For extrahepatic biliary NENs, early detection of tumors, adequate surgery, and aggressive adjuvant treatment for high-risk patients are important to achieve long-term survival and prevent disease recurrence.
Postoperative delirium after cholecystectomy in older patients: A retrospective study
Young Mok Park,Hyung Il Seo,Byeong Gwan Noh,Suk Kim,Seung Baek Hong,Nam Kyung Lee,Dong Uk Kim,Sung Yong Han 한국간담췌외과학회 2023 Annals of hepato-biliary-pancreatic surgery Vol.27 No.3
Backgrounds/Aims: Postoperative delirium (POD) is a common complication that increases mortality and morbidity in older patients. This study aimed to evaluate the clinical significance of post-cholecystectomy delirium in older patients. Methods: This retrospective study included 201 patients aged > 75 years who underwent cholecystectomy for acute or chronic cholecystitis between January 2016 and December 2019. Patients were divided into the POD (n = 21) and non-POD (n = 180) groups, and their demographic features and clinical results were compared. Results: The mean patient age was 78.88 years; the female/male ratio was 44.8%/55.2%. Laparoscopic surgery was performed in 93.5% of patients. The univariate analysis showed that lower body mass index (BMI), immobilized admission status, neuropsychiatric disease history, preoperative intervention (percutaneous drainage), high C-reactive protein, hypoalbuminemia, neutrophilia, hypo-/hyperkalemia, and longer operative time were more frequently observed in the POD group. The multivariate analysis showed that lower BMI (odds ratio [OR], 2.796; p = 0.024), neuropsychiatric disease history (OR, 3.019; p = 0.049), hyperkalemia (OR, 5.972; p = 0.007), and longer operative time (OR, 1.011; p = 0.013) were significant risk factors for POD. Conclusions: POD was associated with inflammation degree, general condition, poor nutritional status, electrolyte imbalance, and stressful conditions. Recognizing risk factors requiring multidisciplinary team approaches is important to prevent and treat POD.