• Tuberculosis and Respiratory Diseases
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• v.41 no.2
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• pp.120-126
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• 1994

Background : Antibiotic therapy has proven an effective method of treatment on the majority of patients with pyogenic lung abscess and infected bulla. When medical therapy has failed, pulmonary resection is the current generally recommended therapy. But nowdays complications of percutaneous tube drainage has decreased with the use of small catheter. So we evaluated the effect of percutaneous tube drainage as an alternative therapy to the pyogenic lung abscess and infected bulla refractory to medical therapy in preference ot the pulmonary resection. Method : Nine cases of the lung abscess and three cases of infected bulla which has large cavity size over 6cm, and has underlying diseases such as lung cancer, diabetes mellitus, refractory to over 1 week of antibiotics, were performed percutaneous tube drainage with All Purpose Drainage catheter(Medi-tech, Watertown, USA) under fluoroscopy. Results : All the cases except one case which complicated empyema was improved clinically. Fever was down within 4days of percutaneous tube drainage(mean : 1.9days). Mean duration of tube drainage was 9.9days. Conclusion : Percutaneous tube drainage is an effective and relatively safe procedure in the management of lung abscesses that do not response to medical therapy. We speculate this procedure should be considered as an alternative therapy for the lung abscess refractory to medical therapy in preference to the surgery. The safety and effectiveness of this procedure in infected bulla should be evaluated with an additional study.

• Advances in pediatric surgery
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• v.9 no.1
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• pp.52-56
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• 2003

A 10 year old boy was admitted with blunt abdominal trauma by bike handle injury. The patient was operated upon for a generalized peritonitis due to pancreaticoduodenal injury. On opening the peritoneal cavity. complete transection of distal end of common bile duct and. partial separation between pancreas head and second portion of duodenum were found. Ligation of the transected end of the common bile duct. T-tube choledochostomy, and external drainage were performed. A pseudocyst was found around the head portion of the pancreas on the 7th postoperative day with CT. An internal fistula had developed between the pseudocyst and ligated common bile duct. The pseudocyst was subsided after percutaneous drainage. In the case of the undetermined pancreatic injury, percutaneous external drainage can be effective in treating the traumatic pancreatic pseudocyst in a pediatric patient.

• Tuberculosis and Respiratory Diseases
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• v.40 no.2
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• pp.153-157
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• 1993

Background: Patients with pyogenic lung abscess who do not respond to medical therapy are usually candidates for thoracotomy with pulmonary resection. Percutaneous tube drainage, used routinely and with good results before the antibiotic era, has nearly been forgotten. Methods: We treated 8 patients who had poor cadidates for a lobectomy and didn't respond to medical management. A pig-tail catheter (6 to 10 Fr.) was inserted into the abscess under the fluoroscopic guidance. Results: All patients brought about dramatic clinical responses with prompt closure of cavity and radiographic improvement. Conclusion: Percutaneous pig-tail catheter drainage provides excellent clnical results with ease and safety, and avoids unnecessary loss of functioning lung parenchyma. But lobectomy should be considered in patients who major life-threatening bleeding or massive pulmonary necrosis.

• Annals of Hepato-Biliary-Pancreatic Surgery
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• v.28 no.1
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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.

• Advances in pediatric surgery
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• v.5 no.2
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• pp.126-129
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• 1999

A 6 and a half year-old girl developed recurrent cholangitis following hepatic portoenterostomy for biliary atresia. Computed tomogram showed an ovoid cyst ($4.5{\times}4.0$ cm in size) in the left hepatic lobe and another tubular dilatation ($2.0{\times}0.8$ cm in size) in the right hepatic lobe. Percutaneous transhepatic cholangiodrainage(PTCD) and cystogram showed an ovoid cyst in the left hepatic lobe (Tsuchida type A), measuring $6.6{\times}5.0$ cm in size. Following drainage and administration of parenteral antibiotics she became afebrile and anicteric. However she continued to drain 45-150 cc of bile per day via the tube over the next 2 weeks. The patient successfully underwent intrahepatic cystojejunostomy with intraoperative ultrasonographic guidance. This case illustrates relapsing cholangitis caused by Tsuchida type A intrahepatic cyst, successfully managed with PTCD followed by an internal drainage procedure.

• Journal of Chest Surgery
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• v.36 no.6
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• pp.404-410
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• 2003

Different treatment options are available according to the stage and duration of the empyema. Stage I empyema (exudate stage) is treated concurrently by the administration of appropriate antibiotics and chest tube drainage. Stage III empyema (organized stage) is considered for decortication through an open thoracotomy. However, the treatment of fibrinopurulent, stage II empyema remains controversial. Recently, debridement with the use of Video-Assisted Thoracoscopic Surgery (VATS) has been proposed for the treatment of stage II empyema. We analyzed and report our initial experience of 5 cases of stage II empyema, treated with the use of VATS. Material and Method: Between June 2001 and February 2002, 5 patients with fibrinopurulent empyema that did not respond to antibiotics, chest tube drainage or Percutaneous Catheter drainage (PCD), and instillation of fibrinolytic agent were treated by debridement and irrigation with the use of VATS. A CT scan was performed in all patients before the operation to confirm the diagnosis of loculated empyema and to detect additional lung parenchymal diseases. Result: All 5 patients underwent successful debridement and irrigation with the use of VATS and the chest tube was inserted properly. And no patients needed conversion to open thoracotomy. The ratio of sex was 4 : 1 (male : female), the mean age was 53 years old (range, 26~73 years), the mean operative time was 73.4 minutes (range, 52~95 minutes), the mean duration of postoperative chest tube placement was 12.4 days (range, 6~19 days), and the mean duration of postoperative hospital stay was 20.8 days (range, 10~36 days). In all patients, clinical symptoms such as pain and fever subsided and simple chest PA view revealed satisfactory lung expansion. No major postoperative complication was observed during the hospital course and no patient suffered from the recurrence of empyema in the follow-up period. Conclusion: We think that early operation with the use of VATS is safe and efficient for stage II empyema which did not respond to medical treatment(antibiotics and chest tube drainage), therefore, it can prevent stage II empyema from advancing to stage III, organized empyema.

• Journal of the Korean Society of Radiology
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• v.83 no.1
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• pp.224-229
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• 2022

Biliary cast syndrome is an unusual complication in patients who have previously undergone liver transplantation. It occurs in approximately 5%-18% of such patients. Rare cases of biliary cast syndrome in patients without liver transplants have also been reported. The pathogenesis of biliary cast has not been clearly identified, although etiologic factors including post-transplant bile duct damage, ischemia, biliary infection, and presence of a post-operative biliary drainage tube have been proposed. Here we present a case of biliary cast that developed in a 49-year-old male who underwent a non-liver surgery after endoscopic and percutaneous management of common bile duct stone.

• Radiation Oncology Journal
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• v.35 no.4
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• pp.380-384
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• 2017

Massive chylous leakage is a rare postoperative complication that can prolong hospital stay and cause secondary morbidities. Conservative management strategies are the treatment of choice; however, radiation therapy (RT) can be used as an alternative for cases that are refractory to conservative treatment. Herein, we report a 69-year-old female patient who suffered from massive chylous leakage after subtotal gastrectomy. Due to persistent massive chylous leakage, she was scheduled to undergo low-dose RT. Radiation was delivered with a daily dose of 1 Gy, using an anterior-posterior and posterior-anterior beam arrangement. The clinical target volume encompassed the entire lymph node area of the D2 dissection. RT was completed at the total dose of 8 Gy because the amount of chylous leakage declined rapidly. Percutaneous drainage tube was removed after 3 days of RT. The patient did not complain of any symptoms related to massive chylous leakage 2 years after the completion of RT.

• Journal of the Korean Society of Radiology
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• v.84 no.6
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• pp.1350-1360
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• 2023

Purpose To evaluate the factors that predict symptomatic dislodgement of a percutaneous transhepatic biliary drainage (PTBD) catheter in patients with malignant biliary obstruction. Materials and Methods This retrospective study included 572 patients with malignant biliary obstruction who underwent 733 PTBD catheter insertions between January 2010 and February 2015. The duration of catheter placement, approach site, location of the catheter tip, insertion angle, presence of a closed-loop pigtail, and tube diameter were evaluated. Results During the follow-up period, 224 PTBD catheter dislodgements (30.56%) were observed in 157 patients. Among them, 146 (19.92%) were symptomatic. The mean duration from catheter insertion until dislodgement was 32 days (range: 1-233 days). Male (odds ratio [OR]: 1.636, 95% confidence interval [CI]: 1.131-2.367, p = 0.009), right-sided approach (OR: 1.567, 95% CI: 1.080-2.274, p = 0.018), increased insertion angle (OR: 1.015, 95% CI: 1.005-1.026, p = 0.005), and incomplete closed-loop pigtail formation (OR: 1.672, 95% CI: 1.098-2.545, p = 0.016) were independent factors predictive of symptomatic dislodgement of a PTBD catheter. Conclusion Factors predictive of symptomatic catheter dislodgement included male sex, a right-sided approach, increased insertion angle, and incomplete closed-loop pigtail formation.

• Journal of the Korean Society of Radiology
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• v.81 no.5
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• pp.1222-1226
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• 2020

Lymphoma is a common cause of nontraumatic chylothorax. Clinical success rates of thoracic duct embolization are lower in patients with nontraumatic chylothorax compared to patients with traumatic chylothorax. Herein, we report a case of nontraumatic chylothorax and lymphoma in a 77-year-old man managed with thoracic duct embolization. The chest tube drainage decreased but not was sufficient to enable removal of the chest tube. Therefore, a second embolization was performed through a direct puncture of the lymphatic mass in the lung, following which the chyle leakage ceased, and the chest tube was removed. The treatment strategy discussed in this report may be an effective therapeutic option for select patients with nontraumatic chylothorax.