• 한국가시화정보학회지
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• 제7권2호
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• pp.22-27
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• 2010

The delayed gastric emptying flows have been visualized in this study when a gastric graft replaced an esophagus after esophagectomy. To construct visualization models for gastric grafts, the path data of gastric graft were extracted from the CT images for real patients and then the experimental models were made from silicone tube by considering elasticity of real stomach. During experiments, 200 ml of water or glycerin was poured into the gastric graft model and the gastric emptying time for total volume of fluid to pass pylorus was measured from the successive images captured by a high speed CCD. The gastric emptying time was compared according to the change of diameter and path (front or rear path) of gastric graft, and pyloroplasty or not. In case that the pyloroplasty was not conducted, the smaller was the diameter of gastric graft, the shorter was the gastric emptying time. However, if the pyloroplasty was conducted, the larger diameter of gastric graft was better for the gastric emptying. Although the rear path gave rise to longer gastric emptying time than the front path, it did not matter, if the pyloroplasty was conducted.

• 대한기계학회논문집B
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• 제36권7호
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• pp.697-703
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• 2012

본 연구에서는 식도 재건 수실 시 유문 성형 여부와 위장 이식편을 이용한 식도 접합 경로에 따른 음식물 역류 현상에 대해 고찰하였다. 위장 이식편의 두 가지 접합 경로(전방, 후방)는 환자 10 명의 CT 영상으로부터 얻어졌으며, 식도관 모델은 RP 로 제작하였다. 식도관은 유문 성형 여부의 두 가지 유문 모델에 연결하였고, 다양한 압력과 펄스폭을 적용하여 역류되는 유체의 체적과 최대 역류 높이를 측정하였다. 그 결과, 역류 체적과 높이는 압력에 따라 증가하였으며, 유문 성형을 하면 전방 경로가 후방 경로보다 역류되는 체적과 높이 작게 나타났다. 역류량은 펄스폭이 증가하면 증가하나 최대 역류높이에 대한 영향은 유문 성형 여부에 따라 달라진다.

• Journal of Yeungnam Medical Science
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• 제39권3호
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• pp.235-243
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• 2022

Background: Intrahepatic cholangiocarcinoma (ICC) of the left liver often shows left-sided lymph node (LN) metastasis. If gastric lesser curvature is extensively dissected, it can induce an iatrogenic injury to the extragastric vagus nerve branches that control motility of the pyloric sphincter and lead to gastric stasis. To cope with such LN dissection-associated gastric stasis, we performed pyloroplasty preemptively. The objective of this study was to analyze our 20-year experience of preemptive pyloroplasty performed in 10 patients. Methods: We investigated clinical sequences of 10 patients with ICC who underwent preemptive pyloroplasty following left hepatectomy and extended left-sided LN dissection. Incidence of gastric stasis and oncological survival outcomes were analyzed. Results: All 10 patients were classified as stage IIIB due to T1-3N1M0 stage according to the 8th edition of American Joint Committee on Cancer staging system. The overall patient survival rate was 51.9% at 1 year, 25.9% at 2 years, and 0% at 3 years. Seven patients showed uneventful postoperative recovery after surgery. Two patients suffered from gastric stasis, which was successfully managed with supportive care. One patient suffered from overt gastric paresis, which was successfully managed with azithromycin administration for 1 month. Conclusion: We believe that preemptive pyloroplasty is an effective surgical option to prevent gastric stasis in patients undergoing extensive left-sided LN dissection. Azithromycin appears to be a potent prokinetic agent in gastroparesis.

• Journal of Chest Surgery
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• 제12권1호
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• pp.67-74
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• 1979

Esophagocardiomyotomy [modified Heller procedure] is a widely accepted operation for relief of dysphagia in patient with esophageal achalasia. But patients with advanced achalasia were more likely to get poorer results from a modified Heller myotomy because of the dependent pouch that creates an angulation at the junction of thick-walled dilated esophagus with the thin wailed aganglionic segment and hinders complete emptying. Thorbjarnarson[1975] proposed the method including truncal vagectomy and pyloroplasty. Vagectomy and pyloroplasty should lesson the severity of acid-peptic esophagitis, if reflux should occur postoperatively. Here we presented 4 cases esophageal achalasia treated by modified Heller operation of 3 cases and one case of Thorbjarnarson method. All postoperative results are good.

• Advances in pediatric surgery
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• 제10권1호
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• pp.22-30
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• 2004

A total of 30 cases of the peptic ulcer in children, who underwent operations from January 1981 to December 1995 because of complications at Department of the Surgery, Chonbuk National University Medical School, is reviewed. Twenty-three were males (76.7%), 7 females (23.3%) and male was preponderant at 3.3:1. There were 25 cases (83.3%) age 10 to 15 years, 3(10.0%) between 2 and 9 years, and 2 (6.7%) below 2. The ulcer was located at duodenum in 27(90.0%), and at stomach in 3 cases (10.0%). Complications were perforation in 19 cases (63.3%), pyloric obstruction in 9 (30.0%) and bleeding in 2 (6.7%). For perforation, truncal vagotomy with pyloroplasty was done in 11 cases, truncal vagotomy with hemigastrectomy and gastrojejunostomy in 6, and simple closure in 2 cases. For obstruction, truncal vagotomy with hemigastrectomy and gastrojejunostomy was done in 5, and truncal vagotomy and pyloroplasty in 3 cases. For bleeding lesions, truncal vagotomy and pyloroplasty was performed in 2 cases. Ten postoperative complications developed in 9 patients: adhesive ileus in 5, recurrence in 2, pneumonia 2, and wound seroma 1 case. One patient developed a primary duodenal perforation and another a recurrent obstruction. Both of patients had symptoms for more than 3 years and were treated with truncal vagotomy and pyloroplasty for the primary operations. Hospital stay was 11.5 days for the patient with perforated ulcer, 11.0 days for the patient with pyloric obstruction, and 14.5 days for the child with bleeding. Average hospital period was 11.6 days. To reduce recurrences after operation, extensive procedure such as distal gastrectomy with vagotomy at the first operation should be considered in case with severe complication or with patients who have been symptomatic for long periods.

• Journal of Chest Surgery
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• 제12권2호
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• pp.75-81
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• 1979

Eophagocardiomyotomy (modi/red Heller procedure) is a widely accepted operation for relief of dysphagia in patients with esophageal achalasia. But patients with advanced achalasia were more likely to get poorer results from a modified Ileller myotomy hecause of the dependent pouch that creates an angulation at the junction of thick-walled dilated esophagus with the thin walled aganglionic segment and hinders complete emptlllg. Thorhjarnarson(1975) prposcd the method including truncal vagectomy and pyloroplasty. Vagectomy and pyloroplasty should lesson the severity of acid-peptic esophagitis, if reflux should occur postoperatively. Here we presented 4 cases esophageal achalasia treated by modified Heller operation of 3 cases and one case of Thorbjarnarson method. All postoperative results are good.

• 한국임상수의학회지
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• 제21권4호
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• pp.398-401
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• 2004

10년령의 암컷 요크셔테리어 개가 간헐적인 구토와 만성 채중감소, 다갈증 그리고 쇠약증으로 건국대학교 수의과대학 부속 동물병원에 내원하였다. 방사선 검사에서 가스와 액체가 찬 위 확장이 확인 되었고, 조영제 투여 후 60분이 경과하여도 조영제가 위에서 소장으로 내려가지 않았다. 초음파 상에서는 위체 부위에 상당량의 액체가 저류 되어 있었고, 유문부 점막이 부후되어 있는 것이 확인되었다. 그래서 유문부 협착으로 의한 위 폐쇄가 강력하게 의심되었다. 수술에서 비대된 위점막은 충분히 제거하였고, Heineke-Mikulicz 유문성형술을 적용하였다. 조직학적 소견상 위점막의 비후와 미약한 미만성의 림포구성 형질세포성 위염을 나타내었다. 모든 소견을 종합하여 볼 때, 만성 비후성 유문 위장애로 진단하였다. 간혈적인 구토와 활력저하는 수술 후 9일간 보였다. 이후 환축은 점차적으로 회복되었다. 한달 뒤 환축은 정상적인 식욕과 활력을 나타내었다.

• Advances in pediatric surgery
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• 제15권2호
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• pp.157-160
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• 2009

Although the incidence of esophageal atresia (EA) is higher in twins than in singletons by two to three times, EA usually affects only one member of twins. We report one pair of twins concordant for EA. A 31-year-old healthy woman bore monozygotic female twins at 36 weeks of gestation. They weighed 2,216 and 2,480 g, respectively. They had EA with distal tracheoesophageal fistula and underwent primary esophageal anastomosis on the birth day and the $2^{nd}$ day of life, respectively. Twin A also had suspicious antral obstruction and pyloroplasty was done simultaneously with esophageal repair. She needed antral web excision for continued gastric stasis one month after $1^{st}$ operation and three balloon dilatations of the esophagus. Twin B recovered uneventfully.

• Journal of Chest Surgery
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• 제8권1호
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• pp.57-60
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• 1975

Congenital esophageal stricture is infrequent disease entity and usually occurs in the mid esophagus. Tracheobronchial remnants in the esophagus causing esophageal stricture are extremely rare, and only few cases were reported in the literature. During last 17 years the authors experienced a case of congenital esophageal stricture due to ectopic tracheal cartilaginous ring who was complicated by peptic esophageal stricture 11 years after esophagogastrostomy. During thoracotomy we thought that the patient had unual achalasia of the esophagus, and couldn`t perform cardiomyotomy because of firm ring encircling the lower esophagus just above the hiatus. The patient was operated on lower esophagectomy including cardia and esophagogastrostomy at his age of two and a half years. Postoperatively the patient did well for 11 years but later he developed intermittent regurgitation without substernal burning, and reoperated under the diagnosis of peptic esophageal stricture-lower esophagectomy, proximal gastrectomy, esophagogastrostomy and Heineke-Mikulicz pyloroplasty with good operative result.

• Journal of Chest Surgery
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• 제7권2호
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• pp.169-174
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• 1974

Duplication of the alimentary tract, especially of the esophagus, have been regarded as rare cong- enital anomalies. However, they are being reported with increasing frequency in the literature. In the . ,- past they have been described by a variety of names, such as "enteric cysts", "intestinal cysts", "giant diverticula", "`mediastinal cysts of foregut origin" "enterogenous cysts" and other descriptive terms. . Most authorities now agree that these anomalies are best described by the term "duplications of the alimentary tract. The duplications [of the alimentary tract] are spherical or tubular structures which poses a well developed smooth muscle layer and are lined with a mucous membrane from any part of the alimentary tract. They may occur at any place in the digestive tube from the tongue to the rectum and usually are intimately attached to some portion of the alimentary tube. We have experienced a duplication of the esophagus in 14 years old middle schoolboy. He complained dysphagia, eructation and substernal pain associated with intermittent high fever and chilliness, increasing in severity for recent three weeks. Routine chest X-ray film revealed nore markable abnormal finding but esophagogram. revealed marked narrowing of the esophagus throughout with a large blind pouch in lower half with fistulous communication at mid portion of the esophagus. On thoracotomy, a large infected blind pouch communicating with the lumen of normal esophagus proximally, Was extended from the level of 5th to 10th thoracic spine. The duplicated segment of the esophagus has a common muscular .wall and proximal communication with the adjacent esophagus. The infected, duplicated esophagus was segmentally resected, and esophagogastrostomy with pyloroplasty was done by displacing the stomach into the right thoracic cavity through midline laparotomy. His Postoperative course was uneventful and discharged without complication.