http://chineseinput.net/에서 pinyin(병음)방식으로 중국어를 변환할 수 있습니다.
변환된 중국어를 복사하여 사용하시면 됩니다.
비신생물성 질환에 대한 췌십이지장 절제술의 안정성 및 수술 후 삶의 질에 대한 평가
은영아(Young A Eun),김상걸(Sang Geol Kim),윤혁진(Hyuk Jin Yun),김종렬(Jong Yeol Kim),김갑철(Gab Chul Kim),염현규(Hyun Kyu Ryeom),김성희(Sung Hi Kim),황윤진(Yun Jin Hwang),윤영국(Young Kook Yun) 대한외과학회 2007 Annals of Surgical Treatment and Research(ASRT) Vol.73 No.1
Purpose: Pancreaticoduodenectomy for mass-like lesions that are suspicious of malignancy sometimes reveals only nonneoplastic disease, especially in those cases where adequate tissues for biopsy are unavailable. In this study, we evaluated the outcomes and quality of life (QOL) after pancreaticoduodenectomy for treating nonneoplastic disease. Methods: The clinical data of 28 patients who underwent pancreaticoduodenectomy for nonneoplatic disease and trauma from Jan. 1992 to Feb. 2006 were reviewed retrospectively. The QOL was evaluated using the FACT-Hep questionnaire. The patients who underwent laparoscopic cholecystectomy for benign gallbladder disease were utilized as the control group. Results: 13.8% (28/203) of all the pancreaticoduodenectomized patients had nonneoplatic disease and trauma. Male patients were predominant (25/28) and all the trauma patients were male. The mean age was 48 (23∼72) years old. The indications for surgery included lesions suspicious for malignancy (16 cases), pancreaticoduodenal artery aneurysm (1 case), and pancreatoduodenal injury (11 cases). The histologic findings of the nonneoplastic lesions revealed benign inflammation of the bile duct (6 cases), chronic pancreatitis (8 cases), pancreatic pseudocyst (1 case), and fibrosis of the Ampulla of Vater (1 case). No surgical mortality occurred. However, the trauma patients group had higher morbidity (72.7% Vs 23.5%, respectively, P=0.01) and a longer hospital stay (68.0 days Vs 32.6 days, respectively, P=0.02) after surgery compared to the nonneoplastic disease patient group. The QOL of the patient who underwent pancreaticoduodenectomy for nonneoplatic disease was not different from that of the control group. Conclusion: Since pancreaticoduodenectomy for nonneoplastic disease was safe and the QOL of the patients was acceptable, it should be performed more often when malignancies can not be excluded from the differential diagnosis.
조자윤(Ja Yun Cho),김종열(Jong Yeol Kim),장수근(Su Kurn Chang),김상걸(Sang Geol Kim),황윤진(Yoon Jin Hwang),윤영국(Young Kook Yun) 대한외과학회 2009 Annals of Surgical Treatment and Research(ASRT) Vol.76 No.4
Purpose: Biliary tract disease is one of the most common causes of acute abdominal pain in elderly patients, but there is still some debate over treatment. The aim of this study is to determine the safety and surgical outcomes of laparoscopic cholecystectomy (LC) for benign gallbladder disease in octogenarian patients. Methods: We selected 42 patients of 80 years or older who underwent LC or open-converted cholecystectomy(OC) from February 1992 to November 2006. We evaluated clinicopathological features, treatment modalities, and surgical outcomes retrospectively. Results: The patients included 17 males and 25 females. The mean age of the patients was 83.3 and 83.7, respectively. Right upper quadrant pain was the most common symptom, present in 85.7% of the patients. Gallstones were present in 85.7%. ASA class Ⅱ and Ⅲ comprised 92.9% of the patients. Comorbidities included hypertension, cardiac disease, pulmonary disease, and diabetes mellitus. Preoperatively biliary drainage was performed in 12 cases (endoscopic drainage in 8, percutaneous drainage in 4 cases). Preoperative cholecystostomy was performed in 5 cases. Emergency operations were more frequent than elective surgery (25 vs. 17). Mean hospital stay of LC patients was 5 days, whereas that of OC patients was 13 days. Open conversion rate was 16.7%. No surgical mortality was present and postoperative morbidity included acute myocardial infarction in one patient and wound infection in one patient. Conclusion: LC in octogenarian patients was safe. However, since the incidence of comorbidities is high in these patients, great care should be taken to evaluate and manage the comorbidities before surgery.
김양우(Yang Woo Kim),윤영국(Young Kook Yun) 대한소화기학회 1993 대한소화기학회지 Vol.25 No.1
N/A The results of surgical treatment in 100 patients with hepatolithiasis including the follow up study on 86 patients from 1985 to 1990 at Kyungpook National University Hospital is presented. The results were as follows. The relative incidence of intrahepatic stones during the period was 13.9% of the 719 cases of surgically treated gall stone disease. The peak incidence of age was 6th to 7th decades (51.0%) and the female was more commonly affected by the ratio of 1:1.7. The most effective means of diagnosis preoperatively were percutaneous transhepatic cholangiography and endoscopic retrograde cholangiography. We performed several types of operation for 100 patients depending on the general condition, the features ot bile duct and location of intrahepatic stones. Patients were treated by 4 different procedures, i.e., common duct exploration in 25 patients, biliary drainage procedure in 29 patients. hepatic resection in 31 patients and hepatic resection with biliary drainage procedure in 13 patients. There were no operative deaths. The stones were completely removed in 47.0% of the patients immediate postoperatively. Residual stones were often observed in the cases with stricture at the right and left intrahepatic ducts. On the follow up of 86 c.ases, 80.2%. were graded as good and fair. Partial hepatic resection was performed in 44 cases and we recommed it when there are unilateral multiple stenoses of intrahepatic ducts.