• Title/Summary/Keyword: 경피적 담도경

Search Result 5, Processing Time 0.018 seconds

A Case of Obstructive Jaundice Secondary to Traumatic Pancreatitis Treated with Percutaneous Transhepatic Biliary Drainage (경피경간담도배액술로 치료한 외상 급성 췌장염에 의한 폐쇄 황달)

  • Park, Ji-Sook;Baek, Jong-Geun;Yeom, Jung-Sook;Park, Eun-Sil;Seo, Ji-Hyun;Lim, Jea-Young;Park, Chan-Hoo;Woo, Hyang-Ok;Youn, Hee-Shang;Shin, Tae-Beom
    • Pediatric Gastroenterology, Hepatology & Nutrition
    • /
    • v.13 no.2
    • /
    • pp.204-209
    • /
    • 2010
  • Isolated pancreatic trauma and secondary obstructive jaundice in the pediatric population is unusual. Biliary tract obstruction can be a major cause of acute pancreatitis. We report a case of obstructive jaundice secondary to isolated traumatic acute pancreatitis in a previously healthy 32-month-old girl. In our case, secondary obstructive jaundice aggravated the pancreatic inflammation and was successfully treated with percutaneous transhepatic biliary drainage (PTBD).

Patient's Selection for Extracorporeal Shock Wave Lithotripsy for Treatment of Common Bile Duct Stones Resistant to Endoscopic Extraction (체외충격파쇄석술 적용을 위한 총담관결석의 선택)

  • Lee, Won-Hong;Son, Soon-Yong;Kim, Chang-Bok;Park, Cheon-Kyoo;Kang, Seong-Ho;Ryu, Meung-Sun;Lee, Yong-Moon
    • Journal of radiological science and technology
    • /
    • v.28 no.2
    • /
    • pp.105-110
    • /
    • 2005
  • Background/Aim : Common bile duct (CBD) stones may cause jaundice, cholangitis, or pancreatitis. Extracorporeal shock wave lithotripsy (ESWL) may be needed whenever endoscopic procedure are failed to extract common bile duct stones. The aim of this study is to provide the standard for patient's best choice on ESWL for treatment of CBD stones resistant to endoscopic extraction. Materials and Methods : Fourty-six patients failed in endoscopic stone extraction including mechanical lithotripsy were treated by ESWL. In all patients, endoscopic sphincterotomy and nasobiliary drainage tube was done before ESWL using the ultrasonography for stone localization with a spark-gap type lithotriptor. Patients were sedated with an intravenous injection of 50 mg of Demerol. None were treated under general anesthesia. Results : Overall complete clearance rate of CBD stone was 89.1% (41/46). In 82.6% of the patients, the stones were extracted endoscopically after ESWL, and spontaneous passage was observed in 6.5%. In the clearance rate after ESWL, there were no noticeable differences with regard to number (single: 82.8%, two or three: 100%, more than three: 100%) and size of the stone (less than 33mm: 92.9%, 33 mm or larger: 83.3%), whereas there were significant differences with regard to the ratio of sum of long-axis length of the all stones to sum of long-axis length of the CBD excluding stone (1:2.4, 1:2.1) and diameter of the largest stone to diameter of CBD excluding stone (1:0.9, 1:0.4) for patients with complete clearance compared with those without. Conclusion : We propose that stones without the fragments are travelable sufficient space in CBD or extractable sufficient diameter of CBD regardless of stone size and number should be treated by other technique to prevent time and cost consuming, such as percutaneous transhepatic cholangioscopylithotomy.

  • PDF

A User Optimer Traffic Assignment Model Reflecting Route Perceived Cost (경로인지비용을 반영한 사용자최적통행배정모형)

  • Lee, Mi-Yeong;Baek, Nam-Cheol;Mun, Byeong-Seop;Gang, Won-Ui
    • Journal of Korean Society of Transportation
    • /
    • v.23 no.2
    • /
    • pp.117-130
    • /
    • 2005
  • In both deteministic user Optimal Traffic Assignment Model (UOTAM) and stochastic UOTAM, travel time, which is a major ccriterion for traffic loading over transportation network, is defined by the sum of link travel time and turn delay at intersections. In this assignment method, drivers actual route perception processes and choice behaviors, which can become main explanatory factors, are not sufficiently considered: therefore may result in biased traffic loading. Even though there have been some efforts in Stochastic UOTAM for reflecting drivers' route perception cost by assuming cumulative distribution function of link travel time, it has not been fundamental fruitions, but some trials based on the unreasonable assumptions of Probit model of truncated travel time distribution function and Logit model of independency of inter-link congestion. The critical reason why deterministic UOTAM have not been able to reflect route perception cost is that the route perception cost has each different value according to each origin, destination, and path connection the origin and destination. Therefore in order to find the optimum route between OD pair, route enumeration problem that all routes connecting an OD pair must be compared is encountered, and it is the critical reason causing computational failure because uncountable number of path may be enumerated as the scale of transportation network become bigger. The purpose of this study is to propose a method to enable UOTAM to reflect route perception cost without route enumeration between an O-D pair. For this purpose, this study defines a link as a least definition of path. Thus since each link can be treated as a path, in two links searching process of the link label based optimum path algorithm, the route enumeration between OD pair can be reduced the scale of finding optimum path to all links. The computational burden of this method is no more than link label based optimum path algorithm. Each different perception cost is embedded as a quantitative value generated by comparing the sub-path from the origin to the searching link and the searched link.

Evaluation of Patient Radiation Doses Using DAP Meter in Interventional Radiology Procedures (인터벤션 시술 시 면적선량계를 이용한 환자 방사선 선량 평가)

  • Kang, Byung-Sam;Yoon, Yong-Su
    • Journal of radiological science and technology
    • /
    • v.40 no.1
    • /
    • pp.27-34
    • /
    • 2017
  • The author investigated interventional radiology patient doses in several other countries, assessed accuracy of DAP meters embedded in intervention equipments in domestic country, conducted measurement of patient doses for 13 major interventional procedures with use of Dose Area Product(DAP) meters from 23 hospitals in Korea, and referred to 8,415 cases of domestic data related to interventional procedures by radiation exposure after evaluation the actual effectives of dose reduction variables through phantom test. Finally, dose reference level for major interventional procedures was suggested. In this study, guidelines for patient doses were $237.7Gy{\cdot}cm^2$ in TACE, $17.3Gy{\cdot}cm^2$ in AVF, $114.1Gy{\cdot}cm^2$ in LE PTA & STENT, $188.5Gy{\cdot}cm^2$ in TFCA, $383.5Gy{\cdot}cm^2$ in Aneurysm Coil, $64.6Gy{\cdot}cm^2$ in PTBD, $64.6Gy{\cdot}cm^2$ in Biliary Stent, $22.4Gy{\cdot}cm^2$ in PCN, $4.3Gy{\cdot}cm^2$ in Hickman, $2.8Gy{\cdot}cm^2$ in Chemo-port, $4.4Gy{\cdot}cm^2$ in Perm-Cather, $17.1Gy{\cdot}cm^2$ in PCD, and $357.9Gy{\cdot}cm^2$ in Vis, EMB. Dose referenece level acquired in this study is considered to be able to use as minimal guidelines for reducing patient dose in the interventional radiology procedures. For the changes and advances of materials and development of equipments and procedures in the interventional radiology procedures, further studies and monitorings are needed on dose reference level Korean DAP dose conversion factor for the domestic procedures.