• Title/Summary/Keyword: 담낭

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A Comparison of Laparoscopic Cholecystectomy with Open Cholecystectomy in a Korean Hospital (복강경담낭절제술과 개복담낭절제술에 따른 진료량 비교)

  • Lee, Eun-Mee;Yu, Seung-Hum;Sohn, Myong-Sei;Kim, Suk-Il
    • Journal of Preventive Medicine and Public Health
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    • v.28 no.2 s.50
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    • pp.325-333
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    • 1995
  • Laparoscopic cholecystectomy was introduced into Korea in 1990 and has been rapidly replacing open cholecystectomy when the indications were met. In this study a medical utilization and technology was assessed on the selected hospitalized patients with cholelithiasis who underwent open or laparoscopic cholecystectomy from April 1, 1991 to March 31, 1994. The results are as follows. Despite the low reimbursement rate by the health insurance, the number of laparoscopic cases have been steadily increased. The post-operative days before health insurance coverage were significantly shortened from 8.4 days to 4.6 days. The preoperative days before health insurance coverage were significantly shorted from 8.4 days to 4.0 days. The total length-of-stays in the hospital were also significantly shortened from 15.2 days to 10.7 and 9.8 days in laparoscopic cholecystectomy. The laparoscopic cholecystectomy showed low expenses in all aspects expect the average hospital charges per day. For the hospital to have cost containment, it is more effective if length-of-stay is shorter because of high daily inpatient hospital charge. The laparoscopic cholecystectomy also showed shortened anesthesia time and operation time compared with open cholecystectomy that were statistically significant. The mean anesthesia and operation time for open cholecystectomy were 113.2 and 90.2 minutes but those of laparoscopic cholecystectomy were 105.7 and 68.6 minutes. According to this study the laparoscopic cholecystectomy has reduced the medical expenditure and we recommend this procedure over open cholecystectomy. The further discussion on the different morbidity rate between two types of procedure is essential in providing quality medical care, and to educate specialist.

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Clinical Study Comparing the Skin Antiseptics of Povidone-iodine and Chlorhexidine-ethanol on Port Site (투관침 부위에 적용하는 포비돈 아이오딘과 클로르헥시딘-에탄올의 소독제 효과 연구)

  • Kang, Min Jung
    • Journal of Convergence for Information Technology
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    • v.10 no.10
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    • pp.80-87
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    • 2020
  • The purpose of this study was to compare in antiseptic effect between povidone-iodine and chlorhexidine-ethanol for laparoscopic cholecystectomy on the port site. A total of 46 patients admitted to surgery at one university hospital in Seoul were included in the study. A study group was randomly assigned using a random number table. The antiseptic effect was evaluated and compared to povidone-iodine and chlorhexidine-ethanol by using a culture and identification of bacteria, measurement of the number of bacteria (CFU/ml) and incidence of surgical site infection. Our results show that povidone-iodine and chlorhexidine-ethanol have no statistically significant difference in the incidence rate of bacteria after 3 minutes of disinfection and before removal of the trocar and in the number of bacteria and the incidence of surgical site infection. Thus, in order to select an efficient and appropriate skin antiseptics, we suggest that it is necessary to consider not only the disinfectant effect but also cost and convenience. In this research, our results about effect and usage of skin antiseptics can be used as basic data and educational resource, and this is expected to improve comprehension of skin antiseptics.

A Case of Churg-Strauss Syndrome with Diffuse Alveolar Hemorrhage Presenting as Acute Acalculous Cholecystitis (미만성 폐포 출혈을 동반한 급성 담낭염으로 발현한 Churg-Strauss 증후군 1예)

  • Kim, Ji Eun;Kim, Ki Uk;Park, Hye-Kyung;Jeon, Doo Soo;Kim, Yun Sung;Lee, Min Ki;Park, Soon Kew
    • Tuberculosis and Respiratory Diseases
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    • v.66 no.3
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    • pp.225-229
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    • 2009
  • Churg-Strauss syndrome (CSS) is a disorder that is characterized by asthma, hypereosinophilia and systemic vasculitis affecting a number of organs. The manifestations of acute cholecystitis and diffuse alveolar hemorrhage are rarely reported in CSS. A 22-year-old woman with bronchial asthma visited our hospital complaining of right upper quadrant pain with a sudden onset. The abdominal computed tomography (CT) scan revealed gall bladder edema consistent with acute cholecystitis. On the initial evaluation, marked hypereosinophilia was observed in the peripheral blood smear. The nerve conduction velocity measurements and a skin biopsy performed to confirm the organ involvement of disease indicated typical mononeuritis multiplex and necrotizing vasculitis, respectively, which was complicated with CSS. On the 12th hospital day, ground glass opacity and consolidations were newly developed on both lung fields. The bronchoalveolar lavage (BAL) fluid showed increasing bloody return in sequential aliquots that were characteristic of a diffuse alveolar hemorrhage. We report a case of CSS with acute cholecystitis and diffuse alveolar hemorrhage.

Recurrence of Choledocholith in the Common Bile Duct after Cholecystectomy in a Dog (개에서 담낭절제술 후 총담관에 재발한 총담관결석증)

  • Chang, Jin-Hwa;Yun, Seok-Ju;Kim, Ju-Hyung;Kang, Ji-Houn;Kim, Gon-Hyung;Na, Ki-Jeong;Chang, Dong-Woo
    • Journal of Veterinary Clinics
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    • v.27 no.5
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    • pp.605-609
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    • 2010
  • A 10-year-old spayed female Yorkshire terrier presented with vomiting, and anorexia. Obstructive choledocholith with concurrent pancreatitis and hepatorenal syndrome was diagnosed based on analyses of the blood profiles, abdominal radiographs, ultrasonography and CT. Choledoliths were removed from the common bile duct, yet the patient died suddenly 10 days after surgery. Recurrent choledolithiasis has not been reported in a cholecystectomized dog and this report focuses on the imaging features of ultrasonography and CT of recurrent choledoliths.

Prevalence and risk factors of gallbladder polyps among adults on Jeju Island according to genders (성별에 따른 제주도 성인의 담낭용종 유병률 및 위험인자)

  • Kwon, Oh-Sung;Lee, Sang-Jun;Kim, Young-Kyu;Jung, Jin-Young
    • Proceedings of the Korean Society of Computer Information Conference
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    • 2021.07a
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    • pp.333-335
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    • 2021
  • Gallbladder polyps (GBPs) may be a cause of gallbladder cancer. The known risk factors for GBPs are male gender, obesity, metabolic syndrome, and dyslipidemia. Especially, male gender has been known that it strongly affects on the prevalence of GBPs. Therefore, this study aimed to investigate risk factors affecting the prevalence of GBPs among adults on Jeju Island according to genders. We examined 5,574 subjects who visited a single health-screening center in Jeju between January 2015 and December 2019. Univariate and multiple logistic regression analysis were performed to identify risk factors affecting the prevalence of GBPs. The prevalence of GBPs were 8.9% in male subjects and 8.1% in female subjects, respectively. Multivariate analysis revealed that ≥60 year age (odds ratio [OR] 0.659; P=0.027) and aspartate aminotransferase >32 IU/L (OR 0.658; P=0.009) in male subjects and high-density lipoprotein-cholesterol ≥60 mg/dL (OR 0.514; P=0.013) in female subjects were independent factors affecting the prevalence of GBPs. The prevalence of GBPs in men (8.9%) is comparable to that in women (8.1%) on Jeju Island. Age <60 years and the high level of aspartate aminotransferase in men and the greater level of high-density lipoprotein-cholesterol in women were independent risk factors of GBPs on Jeju Island.

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Cellular Pathways in Agonist-induced Gallbladder Muscle Contraction in the Cat (고양이의 담낭근 수축에 있어서 세포내 기전)

  • Rhim, Byung-Yong;Kim, Chi-Dae;Kim, Dong-Heon;Biancani, Piero;Behar, Jose
    • The Korean Journal of Pharmacology
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    • v.32 no.1
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    • pp.67-74
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    • 1996
  • Cholecystokinin octapeptide (CCK-8), acetylcholine (ACh) and KCl caused a dose dependent contraction in muscle cells enzymatically digested from cat gallbladder. Maximal contraction was obtained at concentration of $10^{-9}M$ for CCK-8, $10^{-5}M$ for ACh and 20mM for KCl. CCK-8 induced contraction was unaffected in calcium free physiological salt solution (PSS) and was completely blocked by strontium substitution for calcium (p<0.001). In contrast, KCl evoked contraction was blocked in calcium free PSS (p<0.01) but was unaffected by strontium replacement of calcium. The contraction elicited by ACh was only slightly reduced in calcium free PSS (p<0.05) and was unaltered by strontium. Muscle cells permeabilized with saponin contracted in response to inositol 1,4.5-trisphosphate $(IP_3)$ and CCK-8. The contraction was blocked by the calmodulin antagonist CGS 9343B (p<0.001), whereas heparin completely blocked the effect of $IP_3$ (p<0.001). The protein kinase C (PKC) antagonist H7 had no effect on either agonist. We conclude that CCK-8 induced gallbladder muscle contraction is mediated by $IP_3$ dependent intracellular calcium release from intracellular stores and a calmodulin dependent pathway; ACh may utilize both extracellular and intracellular calcium. KCl causes muscle contracrion through influx of extracellular calcium and a calmodulin independent machanism.

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The Role of RBdiotherapy for Locally Advanced Gallbladder Carcinoma (국소적으로 진행된 담낭암에서 방사선치료의 역할)

  • Shin, Hyun-Soo;Seong, Jin-Sil
    • Radiation Oncology Journal
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    • v.18 no.4
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    • pp.283-292
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    • 2000
  • Purpose :A retrospective review of 72 patients with locally advanced gallbladder carcinoma, between January 1990 and December 1996, was peformed. Survival results and prognostic factors are analyzed for the patients treated with a various modalities. Materials and Methods :We patients were classified by treatment modality: group 1 included to 27 patients treated with palliative surgery alone, and group 2 for 11 patient treated with palliative surgery and radiotherapy; group 3 for 18 patients not treated by any treatment modality, and group 4 for 16 patients treated with radiotherapy alone. Age distribution ranged from 35 to 80 years with mean of 63 years. The stage was classified by TNM and Nevin's staging system; all patients had an advanced stage more than III. Palliative surgery was done in .: patients and adiuvant radiation therapy (RT) was followed in 11. For 34 patients, in whom no resection was tried, definitive RT was done in 16. Radiation delivered to tumor site and draining nodes up to 45~61.2 Gy using 10 MV linear accelerator. Chemotherapy was given to 25 patients with 5-FU based regimens. Results :Modian suwival time was 10.3 months and 3-year survival rates (3-YSR) were 13.0$\%$ in all patients. Survival rates according to the treatment modalities were as followed; in palliative surgery alone, 3-YSR was 2.5$\%$; in palliative surgery and adjuvant RT, 3-YSR was 45.5$\%$, in no treatment group, 3-VSR were 8.3$\%$; and definitive RT was 13.1$\%$. It was better survival in additional RT after palliative surgery group than palliative surgery alone (p=0.0009). It was better survival in definitive RT group than no treatment group (p=0.002). Significant prognostic factors by univariate analysis were treatment moonlities, the type of tumor and TNM stage. Significant prognostic factors by multivariate analysis were treatment modalities, the type of tumor and the presence of jaundice. Conclusion : It is suggested that RT could be potentially of effective as adjuvant treatment modalities after palliative surgery or primary treatment for locally advanced and unresectable gallbladder carcinoma.

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Case Report of Primary Carcinosarcoma of the Gallbladder (담낭의 암육종 1예 보고)

  • Jo, Hyang Jeong;Moon, Hyung Bae
    • Journal of Physiology & Pathology in Korean Medicine
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    • v.27 no.1
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    • pp.136-138
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    • 2013
  • Carcinosarcoma of gallbladder is a rare malignant tumor characterized by malignant epithelial and malignant mesenchymal components. Its pathogenesis is unknown and most of carcinosarcomas of gallbladder are associated with poor survival because the disease presents at an advanced stage. A 69-year-old man presented with right upper quadrant pain. The preoperative diagnosis was gallbladder cancer, and thus, curative radical cholecystectomy was performed. Pathologic examination of the surgical specimen revealed that the tumor was composed of carcinomatous components with adenocarcinoma and squamous cell carcinoma, and sarcomatous components with spindle cell sarcoma and chondrosarcoma, which was consistent with a diagnosis of primary carcinosarcoma of the gallbladder. The tumor was found to extend to the pericholecystic fat and no metastasis in regional lymph nodes.

Studies on E-coli Isolated from Bile Juice of Slaughtered Cattle (도축우 담낭에서 분리한 대장균에 관한 연구)

  • 심항섭;우종래;정준용;강순근;고영생;박찬숙;조중현
    • Korean Journal of Veterinary Service
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    • v.14 no.2
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    • pp.127-133
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    • 1991
  • The present study was conducted to investigate the biochemical properties, pathogenicity, antimicrobial test, and serotype of E-coli isolated from slaughtered cattle during the period from March 1991 to May 1991. 1. A total of 12 E-coli isolates were isolated from 132 bile juice of slaughtered cattle. 2. All isolates were resistant to Erythromycin, Cephalothin, Neomycin and Lincomycin while the majority of them were susceptible to Trimethoprimsulfamethoxazol (67%), Chloramphenicol(58%), Gentamicin(58%), Ampicillin(17%), Kanamycin(9%) and Tetracycline (9%). 3. In the test of colicinogenecity and congo-red binding capability, 4(33%) isolates produced colicin, all isolates were congo-red negative. 4. The serotypes of isolated E-coli were identified as 008: K- (2 strain), 015: K- (1 strain), 08: K87: K88ab(1 strain), 0139: Kl2(1 strain), 0147: K89(1 strain), others(6 strains ) were autoagglutination.

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A Case of Gallbladder Stones Associated with Anti-E Antibody Hemolytic Disease in a Neonate (신생아에서 담석을 동반한 Anti-E 항체에 의한 동종 면역성 용혈성 질환 1례)

  • Lee, Hyo-Jin;Hong, Seung-Soo;Sim, Yun-Hee;Kim, Eun-Ryoung
    • Neonatal Medicine
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    • v.15 no.2
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    • pp.190-195
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    • 2008
  • Cholelithiasis is rarely recognized in children, especially in infants. Hemolytic disorders, long-term total parenteral nutrition (TPN), congenital anomalies of the biliary tree leading to stasis of bile flow, congenital IgA-deficiency, furosemide treatment, and prolonged fasting have been reported as predisposing factors for cholelithiasis in childhood. Hemolytic disease of the newborn due to anti-E has rarely been reported as a risk factor for cholelithiasis. We report a case of gallbladder stones in a neonate associated with anti-E antibody hemolytic disease.