Gastroduodenal Lesion Accompanied in Obstructive Biliary Disease / 대한소화기내시경학회지

BACKGROUND AND AIMS: Various gastric and duodenal lesions with gastrofiberscopy were observed in patients with obstructive biliary disease. METHODS: A clinical analysis of the endoscopic findings was carried out on 88 patients with obstructive biliary disease, from February 1994 to January 1998, in the department of Internal Medicine, Chungnam National University Hospital. RESULTS: 1) In the 88 patients, sex distribution showed predominance in the males (47/41) and most of the cases involved those in their 60's. 2) The obstructive biliary diseases were included, common bile duct stones (53.4%), common bile duct cancer (18.2%), pancreatic cancer (18.2%), Klatskin tumor (4.5%) and common hepatic duct cancer (3.4%). 3) The gastroduodenal lesions involved in the obstructive biliary diseases were, erosive gastritis (22.7%), duodenal ulcer (8.0%), gastric ulcer (5.7%), and acute duodenitis (3.4%) in orders. CONCLUSIONS: Significant upper gastrointestinal lesions were found in obstructive biliary disease.

Clinical Observation in Endoscopic Treatment of Colonic Polyps / 대한소화기내시경학회지

BACKGROUND AND AIMS: Colonic polyps are premalignant lesion, whose removal is important for the prevention of colon cancer. METHODS: A series of 116 patients (195 polyps) who undergone colonoscopic polypectomy at Chung Nam National University Hospital from March 1994 to Feb.1997 were analyzed. RESULTS: 1) The ratio of males and females was 81:35, with the average age being in the 60's. 2) Colorectal polyps were found at the rectum (39.5%), sigmoid colon (35.9%). The size of the polyps was less than 0.6 cm in diameter (44.6%), between 0.6 and 1.0 cm (27.7%), between 1.1 and 2.0 cm (22.6%). The number of polyp was single polyp (59.5%). According to the Yamada classification, type III was the most common (43.1%). 3) Histopathologic findings were as follows. Tubular adenomas (58.6%), LSPs was in 3 cases, and malignant changed polyps in 14 case. 4) The malignantly changed polyps peaked in those in their 70's, had sizes ranging between 1.1 and 2.0 cm. Histopathologic finding were villous adenomas (50.0%), tubular adenomas (13.2%), LSPs (33.3%) in orders. CONCLUSION: Although the prevalence of cancer of villous adenomas and LSP was higher than other polyps, the size of the adenomas, their numbers do not seem to influence the malignancy rate in this report.

Effects of Several Methods in Endoscopic Extraction of Common Bile Duct Stone / 대한소화기내시경학회지

BACKGROUND AND AIMS: The objective of this paper is to compare the effectiveness of com-mon bile duct stone extraction by conditions and methods. METHODS: Endoscopic sphinc-terotomies with stone extraction were practiced in 71 patients with common bile duct stones by basket extraction, balloon extraction and mechanical lithotripsy. RESULTS: 1) In 71 patients with CBD stone, sex distribution showed predominence in females (56.3%) and most of the cases were over 60 years old. 2) After sphincterotomy, the overall success rate of the stone extraction was 87.3% (with balloon and basket or mechanical lithotrispy). The removal methods of the stone extractions were varied, but the most commonly used method was basket extraction (50.7%). 3) The complications of sphicterotomy were noted in 10 cases and in 8 cases minor bleeding was stopped with a hypertonic saline epinephrine injection. 4) After the stone extraction, counts and levels of leukocyte, aspartate transami-nase, alanine transaminase, alkaline phosphatase and total bilirubin were significantly improved (p <0.05). 5) Removal methods according to stone size did not show a signifi-cant difference, but the mean size of the stones was different. According to the several methods, the mean diameter of stones were different. The stone size was 1.1 cm in the case of spontaneous removal, 1.4 cm in balloon or basket removal, 1.9 cm in mechanical lithotripsy and 2.0 cm in surgical removal. CONCLUSIONS: Endoscopic stone extraction was effective and safe method with low rate of complications. However there were some significant difficulties in removing large or impacted stones, therefore EHL, ESWL or operation should be considered.

The Cause and Complication of Liver Cirrhosis during the Reccent 5 Years / 대한간학회지

BACKGROUND/AIMS: The causes and complications of liver cirrhosis are varied and increasing prevalence of alcoholic liver disease has been suspected. We tried to categarize the causes and complications of liver cirrhosis. METHODS: We investigated the 159 patients who are diagnosed as liver cirrhosis at Chungnam National University Hospital during the recent 5 years. RESULTS: 1) HBV infection was the most common cause of liver cirrhosis (48.1%), alcohol was next (42.9%). 2) Alcoholic liver cirrhosis was the most common cause in male (54.2%), postnecrotic cirrhosis (HBV) was the most common cause in female (66.7%). The difference was considered to come from the fact that male drinks more, constantly or habitually. 3) Alcohol was the most common cause of liver cirrhosis above the fifth decade of age and HBV is under 40 yeats of age. 4) The complications of liver cirrhosis are variceal bleeding, most common, splenomegaly and ascites in order. Hepatocellular carcinoma occumd also especially in HBV induced liver cirrhosis. CONCLUSION: Alcoholic liver disease is a common cause of liver cirrhosis.