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위전절제술 및 루프 식도공장 문합술을 시행한 환자와 정상인에서 Small Bowel Transit Time 의 비교
김선회(Sun Whe Kim),정준기(Joon Ki Jung),양한광(Han Kwang Yang),김진복(Jin Opk Kim),이명철(Myung chul Lee) 대한소화기학회 1988 대한소화기학회지 Vol.20 No.1
N/A There have been great advances in the operative technique and prevention of early postoperative complications of total gastrectomy. But much more efforts are needed to improve late postoperative complications, nutritional abnormalities after total gastrectoniy. There are many possible causes for malnutrition after total gastrectomy, such as poor oral intake, rnalabsorption due to bacterial proliferation in small bowel and relative pancreatic insufficiency etc. Changes in small bowel transit tirne can be considered as another candidate. The purpose of this study is to compare the small bowel transit time between fifteen patients who didnt show any evidence of recurrence after total gastrectomy and loop esophagojejunostomy due to gastric cancer and six normal volunteers who had no specific gastointestinal symptorns and signs. Fried egg-white which was tagged with 99mTc-SC, rice and water was used as test meal. The transit of the test meal was monitored up to 8 hours by gamma camera which was connected to a microcomputer. 1) The small bowel transit time of head of meal was 221+34.39 minutes in the patients after total gastrectonly and 232.5+26.26 minutes in the control subjects (P>0.05) 2) The small bowel transit time of midportion of meal was 326.0+58.04 minutes in the patiens after total gastrectoinay and 271.8+46.64 minutes in the control suuhjects (P >0.05) 3) There was a tendency of delayed transit time of the later part of meal in the patient group. There was no significant differences in small bowel transit time of head and midportion of meal between patients with weight loss after total gastrectomy ancl normal volunteers. Therefore weight loss as a manifestation of malnutritionn after total gastrectomy is not caused by changes in small bowel transit time.
이한별,이규언,장진영,김선회,윤여규,이건욱,오승근,Han-Byoel Lee,M.D.,Kyu Eun Lee,M.D.,Jin-Young Jang,M.D.,Sun-Whe Kim,M.D.,Yeo-Kyu Youn,M.D.,Kuhn Uk Lee,M.D. and Seung Keun Oh,M.D. 대한갑상선-내분비외과학회 2010 The Koreran journal of Endocrine Surgery Vol.10 No.2
Purpose: Insulinoma is a rare disease for which early diagnosis followed by proper surgical management provides a chance for cure. Analyses of clinicopathological features of patients can help optimize the surgical approach in the treatment of insulinoma. Methods: The records of 13 patients (seven male, six female mean age 44.3 years; age range 17∼62 years) who were diagnosed clinically and pathologically with insulinoma and who underwent surgery between March 1997 and April 2007 at the Department of Surgery, Seoul National University Hospital. Hospital in English please were retrospectively examined. Results: All patients had findings compatible with Whipple's triad. Mean fasting blood sugar was 40.5 mg/dl, serum insulin level was 33.5ՌU/ml, and insulin-to-glucose ratio was 0.6. A prolonged starvation test was performed on six patients. Tumors were localized in 10 patients with a computed tomography (CT) scan and in three patients with CT angiography. Five tumors were located in the pancreas head and uncinate process, five in the body, and four at the body-tail border and tail. Patients underwent resection of tumorby enucleation, distal pancreatectomy, pylorus-preserving pancreaticoduodenectomy, laparoscopic distal pancreatectomy, and duodenum-preserving resection of pancreas head. Four immediate postoperative complications (fluid collection, pancreatic fistula, delayed gastric emptying) occurred. No symptoms or recurrences were apparent during the median 15 month follow-up. Conclusion: Insulinoma is difficult to diagnose correctly without a prolonged duration of symptoms. Localization of insulinoma can be aided by a CT scan and/or CT angiography. Less aggressive operative procedures such as simple enucleation might be a sufficient and feasible procedure for curative resection of benign insulinomas. (Korean J Endocrine Surg 2010;10:99-105)