• 동의생리병리학회지
• /
• 제23권6호
• /
• pp.1465-1469
• /
• 2009

Acute cholecystitis represents an acute inflammation of the gallbladder, caused in most instances by obstruction of the cystic duct, resulting in acute inflammation of the GB wall. Acute cholecystitis usually occurs with right upper quadrant pain and tenderness. This study was designed to evaluated of oriental medicine on acute cholecystitis. The patient who were suffering from acute cholecystitis was treated with herbal medicine such as Gagamsaenggan-tang. After using Gagamsaenggan-tang, we could find remarkable effect on clinical symtoms and lap findings and Abdominipelvic Ultrasonography study. According to results we suggest oriental medical treatment was effective for this patient with acute cholecystitis, but more extensive research is needed.

• 한국간담췌외과학회지
• /
• 제27권3호
• /
• pp.271-276
• /
• 2023

Backgrounds/Aims: Laparoscopic cholecystectomy within one week of acute cholecystitis is considered safe and advantageous. Surgery beyond first week is reserved for non-resolving attack or complications. To compare clinical outcomes of patients undergoing laparoscopic cholecystectomy in the first week and between two to six weeks of an attack of acute cholecystitis. Methods: In an analysis of a prospectively maintained database, all patients who underwent laparoscopic cholecystectomy for acute cholecystitis were divided into two groups: group A, operated within one week; and group B, operated between two to six weeks of an attack. Main variables studied were mean operative time, conversion to open cholecystectomy, morbidity profile, and duration of hospital stay. Results: A total of 116 patients (74 in group A and 42 in group B) were included. Mean interval between onset of symptoms & surgery was five days (range, 1-7 days) in group A and 12 days (range, 8-20 days) in group B. Operative time and incidence of subtotal cholecystectomy were higher in group B (statistically not significant). Mean postoperative stay was 2 days in group A and 3 days in group B. Laparoscopy was converted to open cholecystectomy in two patients in each group. There was no incidence of biliary injury. One patient in group B died during the postoperative period due to continued sepsis and multiorgan failure. Conclusions: In tertiary care setting, with adequate surgical expertise, laparoscopic cholecystectomy can be safely performed in patients with acute cholecystitis irrespective of the time of presentation.

• 한국간담췌외과학회지
• /
• 제27권4호
• /
• pp.388-393
• /
• 2023

Backgrounds/Aims: Acute cholecystitis is a rare condition in pregnant women, potentially affecting the maternal and fetal prognosis. Our aim was to report the main clinical and paraclinical features of acute cholecystitis during pregnancy and therapeutic modalities. Methods: We conducted a case series analysis recording pregnant patients with acute cholecystitis admitted to our surgery department over a period of 11 years. We collected clinical data, paraclinical features, and management modalities related to cholecystitis. Results: There were 47 patients. Twenty-eight percent was in the first trimester of pregnancy, 40% in the second, and 32% in the third trimester. Abdominal pain was located in the right hypochondrium in 75% of cases. Fever was noted in 21% of cases. C-reactive protein was elevated in 39% of patients. Cholestasis markers were high in four patients. Abdominal ultrasound showed a distended gallbladder in 39 patients, with thickened wall in 34 patients, and gallbladder lithiasis in all cases. No patient had a dilated main bile duct. All patients received intravenous antibiotic therapy. Tocolysis was indicated in 32 patients. Laparoscopic cholecystectomy was performed in 32 cases (68%), and open cholecystectomy in 15 cases (32%). Postoperative course was uneventful in 42 patients, and complicated in 5 patients. Rate of complications was statistically higher after open cholecystectomy (p = 0.003). Morbidity rate was higher in the third trimester (p = 0.003). Conclusions: Delay in the diagnosis of acute cholecystitis during pregnancy can lead to serious complications. Management is based on antibiotic therapy and cholecystectomy. Laparoscopic cholecystectomy appears to be less morbid than open cholecystectomy.

• 대한영상의학회지
• /
• 제85권2호
• /
• pp.363-371
• /
• 2024

목적 급성 담낭염은 간동맥 화학 색전술 후에 발생하는 비교적 드물지 않게 발생하는 합병증이며, 대부분 수술적 혹은 중재적 치료 없이 호전된다. 간동맥 화학 색전술 직후에 촬영한 cone beam CT 소견을 이용하여, 수술적 혹은 중재적 치료를 필요로 하는 담낭염의 발생률과 위험인자를 분석하고자 하였다. 대상과 방법 본 연구에서는 6년 동안 시행된 2633건의 간동맥 화학 색전술에 대해 후향적으로 분석하였다. 그중 시술 직후에 촬영한 cone beam CT에서 담낭에 색전 물질이 남아 있는 120명을 선택하여 급성 담낭염의 발생률과 위험인자에 대해 분석하였다. 결과 수술적 혹은 중재적 치료를 필요로 하는 담낭염의 전체 발생률은 0.45%였다. 색전 물질이 남아 있는 환자들 중에서는 10%에서 담낭염이 발생했다. 담낭염이 발생한 12명 중 8명은 담낭동맥의 색전술을 받은 환자들이었다. 결론 대부분의 담낭의 색전물질 침적은 추가적인 치료를 필요로 하지 않고 호전되지만, 담낭동맥의 색전술을 받은 경우에는 담낭염의 발생률이 높아 면밀한 모니터링이 필요하다.

• Tuberculosis and Respiratory Diseases
• /
• 제66권3호
• /
• pp.225-229
• /
• 2009

저자들은 복통을 주소로 내원하여 급성 무결석 담낭염으로 진단받고 치료 중 미만성 폐포 출혈이 발생한 Churg-Strauss 증후군 환자 1예를 경험하였기에 문헌 고찰과 함께 보고하는 바이다.

• 한국간담췌외과학회지
• /
• 제27권4호
• /
• pp.372-379
• /
• 2023

Backgrounds/Aims: While single-incision laparoscopic cholecystectomy (SILC) has advantages in cosmesis and postoperative pain, its utilization has been limited. This study raises the possibility of expanding its indication to acute cholecystitis with the novel method of solo surgery under retrospective analysis. Methods: We compared the outcomes of SILC (n = 58) to those of three-incision laparoscopic cholecystectomy (TILC; n = 117) for acute cholecystitis, being performed from March 2014 to December 2015. Results: Intraoperative results, including the operation time, did not differ significantly, except for drain catheter insertion (p = 0.004). Each group had 1 case of open conversion due to common bile duct injury. There was no significant difference in the length of hospital stay. Either group by itself was not a risk factor for complications, but in preoperative drainage for intraoperative perforation, 3 factors of intraoperative perforation, biliary complication, and history of upper abdominal operation for additional port, only American Society of Anesthesiology (ASA) scores for postoperative complication of Clavien-Dindo grades III and IV were significant risk factors. Conclusions: Our study findings showed comparative outcomes between both groups, providing evidence for the safety and feasibility of SILC for acute cholecystitis.

• 대한핵의학회지
• /
• 제15권2호
• /
• pp.11-17
• /
• 1981

Cholescintigraphic studies with $^{99m}Tc-HIDA$(dimethyl iminodiacetic acid) were performed in 22 cases of normal subjects, 21 of acute cholecystitis, 12 of chronic cholecystitis and 12 others, with the results of, 1) In normal control group, liver and intrahepatic biliary tree, CBD and gall bladder, and G-I tract appeared at 10, 20 and 30 minutes after intravenous injection of $^{99m}Tc-HIDA$ respectively, 2) In acute cholecystitis, 20 among 21 cases showed non-visualization of gall bladder with the diagnostic accuracy, sensitivity and specificity of 93.2%, 95.2% and 100% respectively. 3) In chronic cholecystitis, 5 among 12 cases showed non-visualization of gall bladder and remained 7 among 12 cases showed poor contraction of gall bladder (4), delayed visualization of gall bladder (1) and normal findings (2). 4) In the other disease group, the 12 cases which initially suspected as acute cholecystitis, revealed normal scan findings to exclude the cystic duct obstruction easily, With the above results, this scintigraphic procedure was found very rapid, accurate and easily available method for the determining of the cystic duct patency.

• Pediatric Gastroenterology, Hepatology & Nutrition
• /
• 제17권1호
• /
• pp.57-60
• /
• 2014

Acute acalculous cholecystitis (AAC) is an inflammation of the gallbladder in the absence of demonstrated stones. AAC is frequently associated with severe systemic inflammation. However, the exact etiology and pathogenesis of AAC still remain unclear. Acute infection with Epstein Barr virus (EBV) in childhood is usually aymptomatic, whereas it often presents as typical infectious mononucleosis symptoms such as fever, cervical lymphadenopathy, and hepatosplenomegaly. AAC may occur during the course of acute EBV infection, which is rarely encountered in the pediatric population. AAC complicating the course of a primary EBV infection is usually associated with a favorable outcome. Most of the patients recover without any surgical treatment. Therefore, the detection of EBV in AAC would be important for prediction of better prognosis. We describe the case of a 10-year-old child who presented with AAC during the course of primary EBV infection, the first in Korea, and review the relevant literature.

• 대한핵의학회지
• /
• 제27권1호
• /
• pp.81-87
• /
• 1993

Retrospective analysis of cholescintigraphy and ultrasonography was done in 76 patients with clinically suspected acute cholecystitis to assess the relative value of the two modalities. Excluding the Patients with obstructive jaundice, the overall results of cholescintigraphy(sensitivity 100%, specificity 95%, false positive rate 5%, false negative rate 0%, accuracy 97%) are nearly identical with or rather superior to those of the ultrasonography(sensitivity 94%, specificity 100%, false positive rate 0%, false negative rate 5%, accuracy 97%). We recommend the cholescintigraphy as the initial modality in patients with clinically suspected acute cholecystitis, and ultrasonography can be used in jaundiced patients to exclude the possibility of the false positive of cholescintigraphy.

• Childhood Kidney Diseases
• /
• 제7권1호
• /
• pp.91-95
• /
• 2003

저자들은 4세에 신증후군으로 진단받고 스테로이드를 투여하며 재발을 수 회 반복하던 환자가 갑작스런 복통과 구토를 주소로 입원하여 시행한 검사 상 급성 무결석 담낭염으로 진단받고 금식, 비 위관 배액, 충분한 수액 공급, 그리고 항생제치료로 완치된 경우를 경험하였기에 이를 보고하는 바이다.