• 대한방사선기술학회지:방사선기술과학
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• 제21권1호
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• pp.40-45
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• 1998

To determine its usefulness and safety of extracorporeal shock-wave lithotripsy in common bile duct and pancreatic duct stones, we analyzed the results of 13 patients with common bile duct stones and 6 patients with pancreatic duct stones which were removed by endoscopic procedures using the balloon or basket, who was performed the extracorporeal shock-wave lithotripsy using the ultrasonography for stone localization with a spark gap type Lithotriptor(Dernier MPL 9000, Germany). Fragmentation and complete clearance of the common bile duct and pancreatic duct stones were obtained in 19 of 19 patients(100%). Apart from transient attacks of fever in 2 of 13 patients with common bile duct stones(15%) and mild elevation of serum amylase and lipase in 2 of 6 patients with pancreatic duct stones(33%), no other serious side effects were observed. In our experiences, extracorporeal shock-wave lithotripsy is a safe and useful treatment for endoscopically unretrievable common bile duct and pancreatic duct stones.

• 대한방사선기술학회지:방사선기술과학
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• 제22권1호
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• pp.87-90
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• 1999

Treatment of human calculi by extracorporeal shock-wave lithotripsy(ESWL) was introduced for kidney stones in 1980. This technology was then applied to the treatment of bile duct stones and pancreatic stones. Some reports have also shown that disintegration of pancreatic stones by extracorporeal shock-wave lithotripsy is possible with successful subsequent endoscopic extraction of the fragments at home ana abroad. We tried removal of pancreatic calcification stones by endoscopic procedures, but could't be removed because the basket got entagled in the endoscopy. We report one case of this pancreatic calcification stones ; the stones were successfully fragmented and completely removal by extracorporeal shock-wave lithotripsy.

• Pediatric Gastroenterology, Hepatology & Nutrition
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• 제4권2호
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• pp.256-260
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• 2001

저자들은 반복적으로 췌장염을 앓은 여아에서 상복부 동통을 주소로 내원하여 MRCP와 ERCP를 통해 다발성 췌관석이 원인인 만성 재발성 췌장염 1례를 치험하였기에 보고하는 바이다.

• 한국간담췌외과학회지
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• 제27권4호
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• pp.433-436
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• 2023

Forty-five adults with type IV-A choledochal cysts (CDC) who underwent extrahepatic cyst excision from January 2013 to December 2021 were followed up for a median interval of 25 months (range, 2 to 10 years) to observe the long-term complications in the remaining intrahepatic cyst. Late complications in varying combinations were seen in 10 patients, which included cholangitis and/or intrahepatic stones in 9 patients, intrahepatic bile duct stenosis with stones in 2 patients, anastomotic stricture in 6 patients, and left lobar atrophy with intrahepatic stones in 3 patients. Out of 6 patients who required re-do hepaticojejunostomy (HJ), three patients had left lobe atrophy with patent HJ anastomosis and a recurrent attack of cholangitis on follow-up at 3, 8, and 10 years. Complications occur frequently after extrahepatic cyst excision for type IV-A CDC and require a long-term follow-up.

• 한국간담췌외과학회지
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• 제27권2호
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• pp.166-171
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• 2023

Backgrounds/Aims: Routine execution of intraoperative cholangiography (IOC) in laparoscopic cholecystectomy (LC) is considered a good practice to help early identification of biliary duct injuries (BDIs) or common bile duct (CBD) stones. This study aimed to determine the impact of IOC during LC. Methods: This is a retrospective, monocentric study, including patients with a LC performed from January 2020 to December 2021. Results: Of 303 patients, 215 (71.0%) were in the IOC group and 88 (29.0%) in the no-IOC group. IOC was incomplete or unclear in 10.7% of patients, with a failure rate of 14.7%. Operating time was 15 minutes longer in the IOC group (p = 0.01), and postoperative complications were higher (5.1% vs. 0.0%, p = 0.03). There were three BDIs (0.99%), all included in the IOC group; only one was diagnosed intraoperatively, and the other two were identified during the postoperative course. Regarding identifying CBD stones, IOC showed a sensitivity of 77%, a specificity of 98%, an accuracy of 97.2%, a positive predictive value of 63% and a negative predictive value of 99%. Conclusions: Systematic IOC has shown no specific benefits and prolonged operative duration. IOC should be performed on selected patients or in situations of uncertainty on the anatomy.

• 대한방사선기술학회지:방사선기술과학
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• 제25권2호
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• pp.65-70
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• 2002

1997년 8월부터 2002년 5월까지 서울아산병원에 내원하여 췌관결석 진단을 받은 후, 내시경적 결석제거에 실패하고 ESWL을 시행받은 59명을 대상으로 하였다. 췌관 결석의 방사선학적 특징을 결석 수, 가장 큰 결석의 최대 직경 길이, 결석의 농도, 그리고 생긴 모양으로 분류하였다. 전체대상 59예 중 45예(76.3%)에서 결석의 완전한 제거가 확인되었으며 14예(23.7%)에서는 결석의 완전한 제거에는 실패한 것으로 확인되었다. 1. 단일 결석을 가진 28예 중 21예(75.0%)에서 결석이 완전 제거되었으며, 두 개 이상의 다결석을 가진 31예 중 24예(77.4%)에서 결석이 완전 제거되었다. 2. 결석의 최대 직경이 30m 이하의 경우인 53예 중 41예(77.4%)에서 결석의 완전한 제거가 확인되었으며, 30mm 보다 큰 경우인 6예 중 4예(66.7%)에서 결석의 완전한 제거가 확인되었다. 3. 척추의 체부(body)와 비교한 결석의 농도측면에서, 척추의 체부 보다 농도가 낮은 경우, 즉 비석회화 결석 8예 중 8예(100%) 모두에서 결석이 완전 제거되었으며, 농도가 같은 경우인 43예에서는 37예(86.0%)가 결석의 완전한 제거를 보였으나, 농도가 척추 체부 보다 높은 3예 중 3예(100%) 모두에서 결석의 완전한 제거에 실패하였으며, rim calcified stone 5예 중 5예(100%) 모두에서 또한 결석의 완전한 제거에 실패하였다. 4. 각이진 모양의 결석 9예 중 2예(22.2%)에서 결석이 완전 제거되었으며, 그렇지 않은 원형이나 타원형 모양의 경우인 50예 중 43예(86.0%)에서 결석의 완전한 제거를 확인하였다.

• Pediatric Gastroenterology, Hepatology & Nutrition
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• 제23권3호
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• pp.304-309
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• 2020

An 18-year-old woman with annular pancreas and duodenal duplication presented with recurrent acute pancreatitis and underwent a resection of duodenal duplication. However, the patient experienced recurrent abdominal pain after resection. Abdominal computed tomography and magnetic resonance imaging showed a dilatation of the peripheral pancreatic duct and stenosis and malformation of both the Wirsung's and Santorini's duct due to multiple stones. The modified puestow procedure was performed. The main pancreatic ducts in the body and tail were opened, and the intrapancreatic common bile duct was preserved. A Roux-en-Y pancreatico-jejunostomy was performed for reconstructing the pancreaticobiliary system after removing the ductal protein plug. The patient experienced no abdominal pain, no significant elevation of the serum amylase and lipase levels, and no stone formation during the 2 years of follow-up. This procedure is considered to be beneficial for pediatric patients with chronic pancreatitis due to annular pancreas and duodenal duplication.

• 한국간담췌외과학회지
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• 제28권1호
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• pp.42-47
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• 2024

Backgrounds/Aims: Hepatolithiasis and choledocholithiasis are frequent pathologies and unfortunately, with the current treatment strategies, the recurrence incidence is still high. This study aimed to assess the outcomes of laparoscopic choledochotomy using cholangioscopy via the percutaneous-choledochal tube for the treatment of hepatolithiasis and choledocholithiasis in Vietnamese patients. Methods: A cross-sectional study of patients with hepatolithiasis and/or choledocholithiasis who underwent laparoscopic choledochotomy using intraoperative cholangioscopy via percutaneous-choledochal tube at the Department of Hepatopancreatobiliary Surgery, 108 Military Central Hospital, from June 2017 to March 2020. Results: A total of 84 patients were analyzed. Most patients were females (56.0%) with a median age of 55.56 years. Among them, 41.8% of patients had previous abdominal operations, with 33.4% having choledochotomy. All patients underwent successful laparoscopic common bile duct exploration followed by T-tube drainage without needing to convert to open surgery. Most patients (64.3%) had both intrahepatic and extrahepatic stones. The rate of stones ≥ 10 mm in diameter was 64.3%. Biliary strictures were observed in 19.1% of patients during cholangioscopy. Complete removal of stones was achieved in 54.8% of patients. Intraoperative complications were encountered in two patients, but there was no need to change the strategy. The mean operating time was 121.85 ± 30.47 minutes. The early postoperative complication rate was 9.6%, and all patients were managed conservatively. The residual stones were removed through the T-tube tract by subsequent choledochoscopy in 34/38 patients, so the total success rate was 95.2%. Conclusions: Laparoscopic choledochotomy combined with cholangioscopy through the percutaneous-choledochal tube is a safe and effective strategy for hepatolithiasis and/or choledocholithiasis, even in patients with a previous choledochotomy.

• Journal of Yeungnam Medical Science
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• 제7권2호
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• pp.197-202
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• 1990

저자들은 최근 4일간의 우측 상복부 동통 및 경미한 황달을 주소로 내원한 71세 남자 환자에서 임상적으로 경피적 간담관조영술, 복부 초음파검사, 간기능 검사, 복강 동맥 조영술을 시행하여 Type II Mirizzi 증후군으로 진단된 1예를 치험하였기에 문헌고찰과 함께 보고하는 바이다.

• Advances in pediatric surgery
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• 제9권1호
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• pp.45-51
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• 2003

본 조사 결과는 32개 병원의 39명의 회원에 의해 수술받은 환자 348명의 기록과 회원 37명의 설문 응답자를 분석한 것으로 많은 수의 기록지가 내용이 불충분하거나 일치되지 않은 기술로 인해 자료로서의 한계가 있었다. 특히 췌담관합류 이상에 대한 기록 중 약 절반이 미상으로 기록된 것에서 알 수 있드시 자료가 매우 미흡하였고, 담관낭종의 유형을 정하는 것 예후 인자 및 산 전 진단된 담관낭종의 수술 적기등에 대하여도 회원마다 견해 차이가 있으나 심도있는 토론이 이루어지지 않았다. 따라서 이 결과를 외국의 통계 분석과 비교하는 것 보다는 회원들의 향 후 진료와 연구에 참고가 될 수 있다는 것에 의미를 두고자 하며, 회원들이 동일한 등록지를 작성하는 전향적 연구로 우리나라 담관낭종에 대한 분류, 췌담관 합류이상, 예후 인자들에 대한 재 논의의 출발점이 되기를 기대한다.