• Tuberculosis and Respiratory Diseases
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• 제65권2호
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• pp.131-136
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• 2008

담즙흉은 담도 또는 담낭과 흉강 사이에 형성된 누공을 통해 담즙이 흉강으로 누출되어 흉수의 형태로 관찰되는 흉막염의 일종으로, 주로 흉강-복부 외상과 관련된 매우 드문 합병증이며 그동안 국내에는 담즙흉에 대한 문헌보고가 없었다. 이에 저자들은 최근 외상 후 흉막성 흉통과 호흡곤란을 호소하였고 담도결석 제거를 위한 경피경간담도내시경술 이후에 흉수가 발생한 환자에서 담즙흉으로 진단된 환자 1예를 경험하였기에 보고한다.

• 한국간담췌외과학회지
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• 제27권4호
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• pp.403-414
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• 2023

Backgrounds/Aims: Pancreatoduodenectomy (PD) is recommended in fit patients with a carcinoma (PDAC) of the pancreatic head, and a delayed resection may affect survival. This study aimed to correlate the time from staging to PD with long-term survival, and study the impact of preoperative investigations (if any) on the timing of surgery. Methods: Data were extracted from the Recurrence After Whipple's (RAW) study, a multicentre retrospective study of PD outcomes. Only PDAC patients who underwent an upfront resection were included. Patients who received neoadjuvant chemo-/radiotherapy were excluded. Group A (PD within 28 days of most recent preoperative computed tomography [CT]) was compared to group B (> 28 days). Results: A total of 595 patents were included. Compared to group A (median CT-PD time: 12.5 days, interquartile range: 6-21), group B (49 days, 39-64.5) had similar one-year survival (73% vs. 75%, p = 0.6), five-year survival (23% vs. 21%, p = 0.6) and median time-to-death (17 vs. 18 months, p = 0.8). Staging laparoscopy (43 vs. 29.5 days, p = 0.009) and preoperative biliary stenting (39 vs. 20 days, p < 0.001) were associated with a delay to PD, but magnetic resonance imaging (32 vs. 32 days, p = 0.5), positron emission tomography (40 vs. 31 days, p > 0.99) and endoscopic ultrasonography (28 vs. 32 days, p > 0.99) were not. Conclusions: Although a treatment delay may give rise to patient anxiety, our findings would suggest this does not correlate with worse survival. A delay may be necessary to obtain further information and minimize the number of PD patients diagnosed with early disease recurrence.