Publications (7)6.42 Total impact
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Article: Common bile duct dilatation after cholecystectomy: a one-year prospective study.
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ABSTRACT: Bile duct dilatation after cholecystectomy continues to be a matter of controversy. We aimed determine the magnitude of common bile duct (CBD) dilatation after cholecystectomy followed up to 1 year. Sixty-four cases (age, 47.3 ± 11.7 years; men, 28; women, 36) enrolled in this study. They received laparoscopic cholecystectomy in Chungbuk National University Hospital for symptomatic cholelithiasis or gallbladder polyps with normal bile duct, less than 7 mm. The CBD diameter was measured by one radiologist using ultrasonography at the maximum point after full length evaluation of extrahepatic bile duct. Forty-five and thirty-one cases were followed at 6 months and 1 year, respectively. The CBD was dilated slightly from 4.1 mm at baseline to 5.1 mm at 6 months and 6.1 mm at 12 months after cholecystectomy. The number of cases of CBD dilatation of more than 7 mm at 6 months and at 12 months after cholecystectomy were 11 (24.4%) and 9 (29.0%), respectively. Seven cases at 6 months and 5 cases at 12 months showed bile duct dilation of more than 3 mm compared to baseline. There were no cases having bile duct dilation of more than 10 mm. Postcholecystectomy dilatation of the bile duct occured slightly in most cases. But some cases showed more than 3 mm dilatation over baseline. Asymptomatic bile duct dilatation of up to 10 mm can be considered as normal range in patients after cholecystectomy.Journal of the Korean Surgical Society. 08/2012; 83(2):97-101. -
Article: The value of a laparoscopic interval appendectomy for treatment of a periappendiceal abscess: experience of a single medical center.
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ABSTRACT: Interval appendectomy has been known to be an effective and safe treatment for a periappendiceal abscess, but there is no study on a laparoscopic approach for the treatment of a periappendiceal abscess. The aim of this study is to investigate the value of laparoscopic interval appendectomy. We retrospectively studied 56 patients who had been admitted due to a periappendiceal abscess to Chungbuk National University Hospital from July 2005 to June 2010. Fifteen patients underwent an initial conservative treatment and interval appendectomy. Medical records were reviewed for the postoperative hospital course such as complications, time of initiation of diet, time since stopping antibiotics, symptoms' relief period, and length of hospital stay. All patients received initial conservative treatment [percutaneous drainage insertion (1 case failed) and intravenous antibiotics], and the initial length of hospital stay was 11.6±4.3 days. Percutaneous drainage was removed a mean of 21.7±9.4 days after the initial treatment. Interval appendectomy was performed at a mean of 64.0±17.8 days after initial admission. The duration of use of intravenous antibiotics was a mean of 4.1±1.8 days after laparoscopic interval appendectomy. The complication rate was 1 (6.7%) and the open conversion rate was 1 (6.7%). Our study revealed that initial conservative treatment and laparoscopic interval appendectomy represented a feasible and effective treatment for patients with a periappendiceal abscess.Surgical laparoscopy, endoscopy & percutaneous techniques 04/2012; 22(2):127-30. · 1.23 Impact Factor -
Article: Laparoscopic appendectomy is a safe and beneficial procedure in pregnant women.
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ABSTRACT: Appendectomy is the most common nongynecologic surgery performed during pregnancy. Pregnancy is no longer considered an absolute contraindication for laparoscopic procedures. Laparoscopic appendectomy (LA) is a safe, effective, and beneficial procedure for the treatment of acute appendicitis. However, limited data are available regarding the safety and feasibility of LA during pregnancy. Between May 2005 and May 2009, 20 patients with clinically suspected appendicitis in pregnancy underwent LA at Chungbuk National University Hospital. Clinical data collected retrospectively included demographic information. We compared maternal age, gestational age, operation time, anesthetic time, surgical complications, length of hospitalization, and final outcome of pregnancy. All the 20 patients who underwent LA did not need a conversion. Mean maternal age was 28.1 years (range, approximately 20 to 35 y), gestational age was 15.4 weeks (range, approximately 6 to 30 wk), mean operation time was 45.5 minutes (range, approximately 25 to 90 min), mean length of hospital stay was 4.7 days (range, approximately 2 to 11 d). Fifteen of 20 pregnant women delivered healthy term infants and 5 women have kept a healthy pregnancy. Our data support the accumulating evidence that LA is a safe and feasible procedure for the treatment of acute appendicitis in all trimesters of pregnancy. Close maternal and fetal monitoring is essential during and after the operation.Surgical laparoscopy, endoscopy & percutaneous techniques 02/2011; 21(1):24-7. · 1.23 Impact Factor -
Article: [A case of simple type Caroli's disease confined to right lobe of the liver].
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ABSTRACT: Caroli's disease is a rare congenital hepatobiliary disease characterized by multifocal segmental dilatation of intrahepatic bile ducts affecting all or parts of the liver. Two forms of Caroli's disease are described, the pure form and that associated with periportal fibrosis. The disease may diffusely affect the liver or be localized to one lobe or segment. Less than 20% of all reported cases of Caroli's disease are monolobar type. We report a case of simple type Caroli's disease confined to right lobe of the liver in a 22 year old man. He was admitted due to right upper abdominal pain and diagnosed by magnetic resonance cholangiopancreatography. He was treated with right hepatic lobectomy and recovered completely.The Korean journal of gastroenterology = Taehan Sohwagi Hakhoe chi 11/2007; 50(4):271-6. -
Article: Suppression of proliferative cholangitis in a rat model by local delivery of paclitaxel.
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ABSTRACT: Proliferative cholangitis (PC) leads to biliary stricture, which is the main cause of hepatolithiasis, recurrent cholangitis, and biliary cirrhosis. The aim of this study was to determine whether local delivery of paclitaxel, which inhibits cell proliferation by overstabilization of microtubules, prevents PC in a rat model. PC was induced by introducing a fine nylon thread into the bile duct in a rat. Paclitaxel (100 microl of 10, 100, and 1000 micromol/l) or solvent vehicle was administered into the bile duct for 15 min. One week after treatment, histopathologic examination and 5-bromodeoxyuridine (BrdU) labeling of the bile duct were performed. In comparison with the control, the mean thickness of the bile duct was reduced by 29% in the 1000 micromol/l paclitaxel-treated group (2.61 +/- 0.31 microm vs 3.67 +/- 0.25 micro m, P < 0.05). The luminal area increased ( P < 0.0001) and the grade of epithelial-glandular proliferation was decreased ( P < 0.01) as the dose of paclitaxel increased. Ductal fibrosis and inflammatory cell infiltration were similar in both groups. The BrdU labeling index was significantly lower in the paclitaxel-treated group ( P < 0.05). Local delivery of paclitaxel suppressed PC in a rat model by the inhibition of epithelial-glandular proliferation and may offer an effective therapeutic option for biliary stricture.Journal of Hepato-Biliary-Pancreatic Surgery 01/2003; 10(2):176-82. · 1.60 Impact Factor -
Article: [An experimental model of hepatic fibrosis induced by alcohol and CCl4: can the lipopolysaccharide prevent liver injury induced by alcohol and CCl4?].
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ABSTRACT: It is well known that alcohol enhances the toxicity of CCl4. We tried to establish an alcoholic liver cirrhosis model by administration of alcohol and CCl4 to rats. We also wanted to know the hepatoprotective effect of low doses of lipopolysaccharide(LPS) in this animal model. Of 20 female adult rats, 8 were ingested with alcohol ad libitum(group 1) Another 6 were ingested with 10% alcohol and 50% 1mL/kg CCl4 intragastrically by Sonde twice a week(group 2) The remaining 6 were ingested with 10% alcohol, CCl4, and 0.1mg/kg LPS intraperitoneally twice a week(group 3) The fibrosis was evaluated semiquantitatively on a scale of 0(none) to 3(cirrhosis). 1) After 10 weeks, septal fibrosis or cirrhosis was produced in 9 out of 12 rats in groups 2 and 3 but there was no fibrotic change in group 1. 2) There was no significant difference in pathological grading between groups 2 and 3. Hepatic fibrosis or cirrhosis can be sufficiently induced by alcohol and repetitive CCl4 ingestion for 10 weeks. We can not prove the hepatoprotective effect of low dose LPS by semiquantitative evaluation of pathological grading.Taehan Kan Hakhoe chi = The Korean journal of hepatology 07/2002; 8(2):173-8. -
Article: Symptomatic duodenal diverticulum
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ABSTRACT: To determine management guidelines for symptomatic duodenal diverticulum, we reviewed medical records of 26 patients. Complicated duodenal diverticulum was the only possible cause of symptoms-abdominal pain, fever and chills, melena, vomiting-in 18 patients. Ten patients improved with conservative management, and eight patients underwent diverticulectomy with or without various other procedures. Among the eight patients, one patient who had duodenal fistula died of respiratory complications on the second postoperative day. Symptoms recurred in two patients: One had a distal common bile duct (CBD) stricture and underwent choledochojejunostomy. In the other patient a CBD stone developed 3 years later, and choledocholithotomy and choledochojejunostomy were performed. Eight patients had associated gallstone disease as well as the diverticulum. Five of the eight had a history of operation for gallstone disease; four improved with conservative treatment, and one underwent choledochojejunostomy. Two patients were thought to have an innocent diverticulum and underwent cholecystectomy and choledocholithotomy only. One patient underwent diverticulectomy and sphincteroplasty for a CBD stone and pervaterian diverticulum. In conclusion, operations for duodenal diverticulum should be reserved for seriously complicated diverticula, and the surgeon should be aware that pervaterian diverticulum can be a cause of choledocholithiasis.Con el objeto de definir una gua de manejo para el divertculo duodenal sintomtico, revisamos las historias clnicas de 26 pacientes. El divertculo duodenal complicado fue la nica causa de sntomas-dolor abdominal, fiebre y escalofrios, melena, vmito—en 18 pacientes. Diez pacientes tuvieron mejora con manejo conservador y 8 fueron sometidos a diverticulectoma con o sin olros procedimientos concomitantes. Entre estos ocho, uno, que tena fistula duodenal, murio por complicacin respiratoria en el segundo da postoperatorio. Sntomas recurrieron en dos pacientes. Uno de ellos presentaba estenosis de la via biliar distal, por lo cual se construy una coledoyeyunostoma. En el otro, apareci coledocolitiasis 3 aos ms tarde, por lo cual se practic coledocolitotoma y coledocoyeyunostoma. Ocho pacientes presentaban coleitiasis asociada: 5 de los 8 tenian historia de operacin por colelitiasis y 4 mejoraron con manejo conservador y en 1 se practic coledocoyeyunostoma. Dos pacientes parecan tener divertculos inocentes y fueron sometidos a colecistectoma y coledocolitotoma solamente. En uno se practic diverticulectoma y esfinteroplastia por coledocolitiasis y un divertculo pervateriano. En conclusin, la operacin para el divertculo duodenal debe ser reservada para los divertculos con complicaciones graves y el cirujano debe tener conciencia de que el divericulo pervateriano puede ser causa de coledocolitiasis.Pour dterminer une attitude thrapeutique vis--vis du diverticule duodnal symptomatique, nous avons revu 26 dossiers mdicaux. On a estim que des symptmes comprenant douleur abdominale, fivre, frissons, mlna et vomissements, observs chez 18 patients, taient en rapport avec un diverticule duodnal compliqu. Dix patients ont t traits de faon conservatrice, alors que huit patients ont eu une diverticulectomie associe ou non un autre procd. Parmi ces huit patients, un patient qui avait eu une fistule duodnale est dcd au deuxime jour. Les symptmes ont rcidiv chez deux patients. Un de ces patients, ayant une stnose de la voie biliaire principale, a eu ensuite une anastomose choldocojjunale. Le dernier patient a dvelopp une lithiase de la voie biliaire principale trois ans aprs, qui a ncessit une choldocotomie suivie d'une anastomose choldocojjunale. Huit patients avaient aussi une lithiase vsiculaire associe leur diverticule. Cinq des huit patients avaient dj eu une opration pour leur lithiase, quatre ont t amliors par un traitement conservateur et un autre a eu une anastomose choldocojjunale. Chez deux patients ayant un diverticule asymptomatique, seule une cholcystectomie et une choldocotomie ont t pratiques. Un patient a eu une diverticulectomie et une sphinctrotomie pour lithiase choldocienne et diverticule paravatrien. En conclusion, le traitement du diverticule duodnal doit tre rserv pour les cas compliqus et le chirurgien devrait savoir que le diverticule paravatrien peut ventuellement tre une cause de lithiase choldocieme.World Journal of Surgery 08/1995; 19(5):729-733. · 2.36 Impact Factor
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1995–2011
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Chungbuk National University
- Department of Internal Medicine
Tyundyu, North Chungcheong, South Korea
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