• 제목/요약/키워드: Hepatobiliary complication

검색결과 16건 처리시간 0.02초

A case series of emergency pancreaticoduodenectomies: What were their indications and outcomes?

  • Kit-Fai Lee;Janet Wui Cheung Kung;Andrew Kai Yip Fung;Hon-Ting Lok;Charing Ching Ning Chong;John Wong;Kelvin Kai Chai Ng;Paul Bo San Lai
    • 한국간담췌외과학회지
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    • 제27권4호
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    • pp.437-442
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    • 2023
  • Emergency pancreaticoduodenectomy (EPD) is a rarely performed operation. It is important to know the indications and outcomes of EPD to have a better understanding of its application in clinical practice. A review of eight consecutive cases of EPD was done. Between January 2003 and December 2021, 8 out of 370 patients (2.2%) in a single center received pancreaticoduodenectomy as emergency. There were six males and two females with a median age of 45.5 years. The indications were trauma in three patients, bleeding tumors in two patients, and one patient each in obstructing duodenal tumor, postoperative complication and post-endoscopic retrograde cholangiopancreatography (ERCP) complication. The median operative time and blood loss were 427.5 minutes and 1,825 mL, respectively. There was no operative mortality. Seven patients (87.5%) had postoperative complications. Three patients (37.5%) developed postoperative grade B pancreatic fistula. The median postoperative hospital stay was 23.5 days. Five patients were still alive while three patients survived for 13, 31, and 42 months after the operation. The causes of death were recurrent tumors in two patients, and sepsis in one patient. According to this case series, EPD is associated with increased morbidity and pancreatic fistula, but is still deserved in life-threatening situations and long-term survival is possible after EPD.

내시경 담낭절제술에 발생한 담도손상의 간담도스캔 (Hepatobiliary Scanning of the Common Bile Duct Injury after Laparoscopic Cholecystectomy)

  • 전석길;이희정;조원현
    • 대한핵의학회지
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    • 제28권1호
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    • pp.141-144
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    • 1994
  • 내시경 담낭절제술은 개복수술보다 여러가지 장점이 있어서 점차 보편화되는 경향이지만 이에 수반하는 합병증도 여러가지가 발표되고 있으며, 그 가운데 담도손상으로 인한 담즙유출은 재수술을 요한다. 저자들은 43세의 남자와 54세의 여자에서 내시경 담낭절제술후에 발생한 복강내 담즙유출을 $^{99m}Tc$-DISIDA 간담도 스캔으로 확진하고 이의 유용성을 증례와 함께 보고하는 바이다.

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영아 자발성 총담관 천공의 간담도 스캔 (Hepatobiliary Scan in Infantile Spontaneous Perforation of Common Bile Duct)

  • 전석길;류종걸;이은영;이종길
    • 대한핵의학회지
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    • 제30권1호
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    • pp.126-129
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    • 1996
  • Spontaneous perforation of CBD in infant is a rare but fatal disease. We report a case of bile leakage from common bile duct in 11 months old girl with progressive abdominal distension and vomiting, preoperatively diagnosed by hepatobiliary scan with 99mTc-DISIDA, which was confirmed by surgery, Operative cholangiogram showed a small perforation at the confluence of cystic duct and common bile duct with mild fusiform dilatation, and no definite abnormality in confluence of the common bile duct and pancreatic duct. Simple drainage of the free peritoneal bilous fluid and T-tube drainage were performed without any evidence of the complication. Patient was inevitable for 6 months OPD follow-up examination.

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복강경담낭절제술에서 수술전 간담도신티그라피와 경구담낭조영술의 의의 (The Role of Hepatobiliary Scintiuaphy and Oral Cholecystography in Predicting the Performance of Laparoscopic Cholecystectomy)

  • 원경숙;문대혁;양승오;한동복;박철민;이문규;이희경;박광민;이승규;류진숙
    • 대한핵의학회지
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    • 제31권1호
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    • pp.102-107
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    • 1997
  • 복강경담낭절제술은 대부분의 담낭질환 환자의 치료에 널리 쓰이는 수술방법이다. 이 연구의 목적은 복강경담낭절제술의 적용여부를 결정하는 수술전 검사로 행해지고 있는 간담도신티그라피와 경구담낭조영술의 복강경담낭절제술의 난이도 예측에 대한 유용성을 알아보는 것이다. 176명의 환자에서 간담도신티그라피와 경구담낭조영술을 시행하고 한달 이내에 복강경담낭절제술을 시행하였다. 간담도신티그라피와 경구담낭조영술에서 담낭이 관찰되지 않은 소견을 심한 담낭질환을 나타내는 지표를 하여, 환자군을 간담도신티그라피와 경구담낭조영술에서 담낭이 보이는 소견에 따라 나누어서 복강경담낭절제술의 난이도를 나타내는 개복술로의 전환, 수술중 합병증 발생, 수술시간을 비교 분석하였다. 담낭이 보이는 소견에 있어 두 검사의 일치율은 89.2%로 높았다. 두 검사상 담낭이 보이지 않았던 군에서 개복술로의 전환율과 수술중 합병증 발생률이 유의하게 높았으며, 수술시간도 길었다. 결론적으로 간담도신티그라피와 경구담낭조영술 모두 복강경담낭절제술의 난이도를 예측하는데 유용하였으며, 두 검사 사이에 유의한 차이는 관찰되지 않았고 높은 일치율을 보였다. 이러한 결과는 이들 검사를 토대로 복강경담낭절제술의 난이도를 예측가능하게 함으로써 치료방법의 선택과 환자에 대한 상담에 도움을 줄 것으로 생각된다.

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원인불명의 담즙흉 1예 (A Case of Cholethorax Developed by Unknown Cause)

  • 성문혁;김성무;유숙희;박우리;안진영;최강현;이기만;김시욱
    • Tuberculosis and Respiratory Diseases
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    • 제70권3호
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    • pp.261-265
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    • 2011
  • Cholethorax is a bilious pleural effusion caused by a pleurobiliary fistula or leakage of bile into the pleural space. Most cases of cholethorax arise from a complication of abdominal trauma, hepatobiliary infection, or invasive procedures or surgery of hepatobiliary system. However, we experienced a case of a patient with cholethorax of unknown origin. There was no evidence of pleurobiliary fistula or leakage of bile from the hepatobiliary system although we examined the patient with various diagnostic tools including chest and abdominal computed tomography, endoscopic retrograde cholangiopancreatography, tubography, bronchofiberscopy, hepatobiliary scintigraphy and video-assisted thoracoscopic surgery. Herein we report a case of cholethorax for which the specific cause was not identified. The patient was improved by percutaneous drainage of pleural bile.

A Complication of Diaphragm Repair Using a Gore-Tex (Expanded Polytetrafluorethylene) Membrane: A Case Report

  • Lee, Seungwook;Hong, Sung Yeon;Son, Jung A;Hyun, Seungji;Haam, Seokjin
    • Journal of Chest Surgery
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    • 제55권2호
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    • pp.171-173
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    • 2022
  • A 65-year-old man underwent right trisectionectomy of the liver and reconstruction of the chest wall and diaphragm with a 2-mm Gore-Tex membrane due to recurrent hepatocellular carcinoma. After 3 years, the Gore-Tex membrane in the diaphragm migrated to the abdominal cavity and perforated the colon. We report a rare complication of a Gore-Tex membrane after diaphragm repair.

담낭염과 폐렴을 동반한 전염성 단핵구증 1례 (A Case of Thickened Gallbladder Wall and Pneumonia in a Child with Infectious Mononucleosis)

  • 김현수;김형석;신영규;은백린;박상희;차상훈
    • Pediatric Infection and Vaccine
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    • 제4권1호
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    • pp.167-173
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    • 1997
  • Acute infectious mononucleosis, caused by Epstein-Barr virus(EBV), is a self limited lymphoproliferative illness that is common in adolescents and young adults. It shows many complications in multiple organ systems, but the hepatobiliary and the respiratory complication is uncommon. We report a case with thickened gallbladder wall and pneumonia as complications of acute infectious mononucleosis in a child. Also the related literature were reviewed. A 4 year old boy presented with a history of high fever, cough, and abdominal distension for 20days. Physical Examination revealed audible crackles in whole lung field and gross hepatomegaly. Chest X-ray showed pneumonia and liver function tests were abnormal. Ultrasonography and computed tomography revealed a thickened gallbladder wall and hepatosplenomegaly. The diagnosis of primary Epstein-Barr viral infection was eventually made by specific serologic tests. The patients's fever subsided 6 weeks later and pneumonia was recovered around this time. Liver function tests returned near normal 2 months later and ultrasonography of gallbladder was normal at this time.

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In Vitro Effects of SB202190 on Echinococcus granulosus

  • Lv, Hailong;Li, Siyuan;Zhang, Jing;Liang, Weihua;Mu, Xiaoling;Jiang, Yufeng
    • Parasites, Hosts and Diseases
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    • 제51권2호
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    • pp.255-258
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    • 2013
  • Spillage of cyst contents during surgical operation is the major cause of recurrence after hydatid cyst surgery. Instillation of a scolicidal agent into a hepatic hydatid cyst is the most commonly employed measure to prevent this complication. SB202190 is a pyridinyl imidazole derivative and is known to be a specific inhibitor of p38 MAPK. In the present study, the scolicidal effect of SB202190 was investigated. Freshly isolated Echinococcus granulosus protoscolices were subjected to SB202190 treatment (10, 20, 40, and $80{\mu}M$), and the effects on parasite viability were monitored by trypan blue staining. Corresponding effects were visualized by scanning and transmission electron microscopy. Dose-dependent protoscolex death within a few days of SB202190 treatment was observed. Although the in vitro scolicidal effect of SB202190 was satisfactory, the in vivo efficacy of this drug and also possible side effects remain to be further investigated.

소아 담관낭종의 로봇수술의 초기경험 (Initial Experience of Robot-assisted Resection of Choledochal Cyst in Children)

  • 장은영;장혜경;류선애;오정탁;한석주
    • Advances in pediatric surgery
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    • 제17권1호
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    • pp.72-80
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    • 2011
  • Although laparoscopic surgery for hepatobiliary disease in children is possible, it is technically challenging. In an attempt to overcome these difficulties, the da Vinci Robotic Surgical System$^{(R)}$ was used to facilitate the minimally invasive treatment of choledochal Cyst in six children. In early consecutive three cases, we experienced three complications; a case of laparotomy conversion, a case of late stenosis of the hepaticojejunostomy, and a case of leakage from a hepaticojejunostomy. However, in the last three cases the complete resection of the choledochal cyst and Roux-en-Y hepaticojejunostomy were performed using the robotic surgical system without complication. We think robot-assisted choledochal cyst resection in children appears safe and feasible, and may increase the variety of complex procedures in pediatric surgical fields.

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