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- 저자 : 권굉보(Koing-Bo Kwun) (검색결과 77 건)
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권굉보(Koing Bo Kwun),이수정(Soo Jung Lee),김재황(Jae Hwang Kim),노성균(Seung Gyun Roh),서우석(Woo Seok Seo) 대한소화기학회 1992 대한소화기학회지 Vol.24 No.5
This study analyzes the first 100 cases of laparoscopic cholecystectomies(L.C) performed at Yeungnam university hospital during seven months from May 1991 to January 1992. Patients were mostly female(63%), with average age of 46.9 years old. There were 68 cases of choiecystitis with stones (acute 13, chronic 55), 5 case of gall stones associated with common bile duct stones, 6 cases of acalculous cholecystitis, and 1 case of polyp. Preoperative upper abdominal sonogram was done in all patient. Oral cholecystograms were performed in 19 cases who demonstrated no evidence of stone on sonogram. ERCP evaluations were done for 20 patients who showed either a dilated common blie duct(CBD) or presence of stone in CBD on sonogram, or elevated serum bilirubin. CBD stones proven by ERCP in 5 patients were removed by papillotomies before L.C. Authors preferred to dissect the gall bladder starting from the fundus toward hilum instead of beginning from hilum. Both a contact Laser and an electric cautery were equally effective for the dissections. Routine operative cholangiogram was not performed. The operation time ranged between 18-200 minutes with average 70.4 minutes. But it had been reduced to 53 minutes for the last 10 cases. Only 59 patients required analgesics after L.C (31 for 1 day, 10 for 2 day, 18 for 3 day). In 5 cases L.C had to be converted to O.C because of extremely hard contracted gall bladder in 2 cases and mistakes from poor operation skills in 3 cases. Operative complications developed in 13 cases (12.3%) and which included a mesenteric tear by a trocar trauma in one case, Richter's hernia through infraumbilical puncture site in one, CBD injuries in two, misinsertion of laparoscope into falciform ligament in one, bleeding in two, bile leaks in two, prolonged ileus in two and wound seroma in two. Almost all patients were able to take fluid diets on the first postoperative day and were to be discharged from hospital by the 4th postoperative day. These results suggested that laparoscopic cholecytostomy is an effective alternative method for the removal of gall bladder, but operative skills have to be improved to reduce complications.
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권굉보(Koing Bo Kwun) 대한외과학회 2007 Annals of Surgical Treatment and Research(ASRT) Vol.72 No.1
Although the subspecialization of surgical practice and fellowship training have progressed well in most of the university hospitals in Korea, no apparent supervision system has yet been activated. There have recently been active debates and discussions between society members on the issue of a certification for fellowship training, which ultimately prompted the Korean Surgical Society to prepare appropriate measures. In order to facilitate the process of establishing ideal measures, in our unique circumstance of surgical practice, I can suggest some of my personal opinions. First of all, I recommend that the Korean Surgical Society and its all member to strive against government interference and achieve an attending system for surgical practice and to obtain reasonable insurance reimbursement for surgeons’ work, which are all prerequisites for both general and subspecialty surgical practices. Rigorous criteria for approval and credentialing of a fellowship training program should be established, whether certification will be given or not. Certification should be offered only when there is agreement between all the members of subspecialty boards and the association of practicing surgeons. All measures should be taken so as not to compromise surgical residency training by subspecialty fellowship. As subspecialization progresses, the specialty of general surgery also needs to be redefined. A discreet long-range plan of the surgical work force should be done to keep the proper number of both generalist- general surgeons and subspecialist-general surgeons. In order to take the initiative for the moderation of the interests between different subspecialty boards, and to establish a structured fellowship training program, the Korean Surgical Society should reinforce its administrative functions.
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김석범,권굉보,강복수,김기홍,Kim, Seok-Beom Gib,Kwun, Koing-Bo,Kang, Pock-Soo,Kim, Ki-Hong 한국의료질향상학회 1998 한국의료질향상학회지 Vol.5 No.1
A mailed survey with structured questionnaire was conducted to study the demand of private physicians who were operating their own clinics in the community to be a attending physician at the general hospital. The responding proportion was 21.6 percent of the 960 private physicians. A total of 207 responders; 65.2 percent wanted to be a attending physician. In particular, the physicians who were male, young, surgeon and teaching hospital careered after specialist were more highly motivated. The major activities what they wanted as a attending physician were medical care for the admission patients. They responded that the hospital charges for the medical services and the responsibility of malpractice issues should be fairly shared by attending physician and hospital according to their contributions. There is growing consensus that the need of attending physician at the general hospital will become wide spread, but little organizational preparation to assure the quality of medical care of attending physicians including training of resident physicians and students. In addition, the effective reimbursement system should be develop to compensate appropriately according to the medical achievement of the attending physicians.
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