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First experiences with laparoscopic assisted distal gastrectomy
Ye Seob Jee 대한외과학회 2012 Annals of Surgical Treatment and Research(ASRT) Vol.83 No.3
Purpose: Recently, the number of laparoscopic gastric surgeries increased in Korea. But since many patients prefer to attend larger hospitals, most operations have been performed in high volume center by experienced surgeons, and also most reported studies on laparoscopic gastric surgery have been performed in these hospitals. For better health service and increased access of local residents, district hospitals that have a smaller number of surgical cases also need to perform this surgery safely. Methods: We retrospectively analyzed 58 patients who underwent laparoscopic assisted distal gastrectomy (LADG) from April 2009 to January 2012 in Dankook University Hospital. We compared our data with the retrospective data of the Korean Laparoendoscopic Gastrointestinal Surgery Study (KLASS) group because we thought the KLASS study was a representative study of LADG. Results: A total of 58 patients underwent LADG during a period of 32 months. The male to female ratio, mean age and body mass index were 34:19, 62.4 years and 23.0 kg/m2, respectively. More than D1 + β lymph node was dissected in all patients and the mean number of harvested lymph nodes was 31.4. Mean operation time, estimated blood loss and mean hospital stays were 235 minutes, 176 mL and 7.4 days respectively. During the operation, there were no complication and no conversions to open surgery. After the operation, there were 2 cases of wound complication and 1 case of intra-abdominal abscess which improved with conservative treatment and there was no mortality. These data were not different to the data of high volume centers, especially KLASS. Conclusion: We report first experience with LADG and concluded that LADG could be performed safely in smaller scale hospitals.
소화관영양처방의 잔류물의 고형화에 의해 발생된 식도막힘
조한철 ( Hancheol Jo ),장예림 ( Ye Rim Chang ),김소미 ( So Mi Kim ),김동욱 ( Dong Wook Kim ),지예섭 ( Ye Seob Jee ) 한국정맥경장영양학회 2018 한국정맥경장영양학회지 Vol.10 No.1
The nutritional support of acutely ill patients is very important and early enteral nutrition is recommended. Feeding via the nasogastric route is used widely for its ease of access if the patient cannot maintain volitional food intake. If the position of the tip or side holes of the nasogastric tube (NGT) is above the gastroesophageal junction, there is the possibility of retention and solidification of the administered enteral feeding formula in the esophagus. Therefore, the tip of the NGT should be checked carefully; a chest radiograph to confirm its position can be considered, especially in patients with a higher risk of aspiration and gastroesophageal reflux. In addition, careful consideration of the risk factors that can trigger esophageal obstruction is required when feeding patients in the intensive care unit. This paper describes two unusual cases of esophageal obstruction caused by the solidification of residue of an enteral feeding formula.
Gastrojejuno-colic fistula after gastrojejunostomy
Kil Hwan Kim,Ye Seob Jee 대한외과학회 2013 Annals of Surgical Treatment and Research(ASRT) Vol.84 No.4
Gastrojejunocolic fistula is a rare condition after gastrojejunostomy. It is severe complications of gastrojejunostomy, which results an inadequate resection or incomplete vagotomy during peptic ulcer surgery. The symptoms are diarrhea, upper abdominal pain, bleeding, vomiting and weight loss. A 55-year-old man with chronic diarrhea and weight loss for 6 months visited Dankook University Hospital. The patient had received a truncal vagotomy and gastrojejunostomy for duodenal ulcer obstruction 15 years previously. The patient underwent gastroscopy and upper gastrointestinal series evaluations, which detected the gastrojejunocolic fistula. After improving of malnutrition, an exploratory laparotomy was undertaken, which revealed that the gastrojejunostomy site and the T-colon formed adhesion and fistula. En block resection of the distal stomach and T-colon included the gastrojejunocolic fistula, and Roux-en-Y gastrojejunostomy was performed. Recovery was uneventful and the patient remained well at the follow-up. We report a gastrojejunocolic fistula, which is a rare case after gastrojejunostomy.