Résumé
Laparoscopic cholecystectomy is the newest treatment modality to be introduced for the management of the gallstone disease and is gaining rapid acceptance elsewhere. Despite its rapid and widespread acceptance, early data suggest that some complications and limitations are common when compared to standard cholecystectomy. The aim of this study was to identify problems in laparoscopic cholecystectomy and the reasons for secondary or operative conversion. From August 1991 to December 1994, 195 consecutive patients were treated with laparoscopic cholecystectomy at the Department of General Surgery, Kangdong Sacred Heart Hospital, College of Medicine, Hallym University. The results were as follows; 1) The most prevalent age group was the 5th decade (24.6%) and the sex ratio (M : F) was 1 : 1.4. 2) The most common symptom was right upper quadrant pain (66.2%). 3) The majority (66.7%) of the admitted patient came to our hospital within 6 months of the onset of symptoms. 4) The number of patients with previous abdominal operations was 44 patients (22.6%), and the most common operation was an appendectomy (8.2%). 5) The patients with associated diseases were 124 patients (63.6%), gastritis being noted in 35 patients (17.9%). 6) The preoperative diagnostic rate was 96% by abdominal ultrasonography and 23.6% by ERCP 7) The average operative time was 103 minutes. 8) The most frequent operative finding was adhesion (72.3%). 9) The mean period of hospitalization after operation was 3.5 days. 10) The most dominant type in pathologic classification was chronic cholecystitis (86.7%). 11) The number of conversions to an open cholecystectomy was 14 (7.2%). 12) Among 195 patients, complications were noted in 10 patients (5.1%) : bile leakage from the bile duct or the liver bed(3 patients), bile duct injury (2 patients), subphrenic abscess (2 patients), atelectasis (1 patient), wound hematoma (1 patient), and drain site bleeding (1 patient).
Sujets)
Humains , Appendicectomie , Bile , Conduits biliaires , Cholangiopancréatographie rétrograde endoscopique , Cholécystectomie , Cholécystectomie laparoscopique , Cholécystite , Classification , Calculs biliaires , Gastrite , Coeur , Hématome , Hémorragie , Hospitalisation , Foie , Durée opératoire , Atélectasie pulmonaire , Sexe-ratio , Abcès sous-phrénique , Échographie , Plaies et blessuresRésumé
No abstract available.
Sujets)
Animaux , Rats , Allopurinol , Foie , Lésion d'ischémie-reperfusion , VérapamilRésumé
No abstract available.
Résumé
A total of 212 cases of gastric carcinoma resected at Kang-Dong Sacred Heart Hospital during the period of 4 years from December 1986 to December 1990 were examined according to Borrmann, Mulligan-Rember, Ming and WHO methods based on histopathological investigations. In Mulligan-Rember (M-R) classification, intestinal cell type (IC) was frequently seen in Borrmann type I and II; pyloro-cardiac gland cell type (PC) in II and III, and mucous cell type (MC) in IV and III. Expanding growth pattern was more frequent in IC, infiltrative growth pattern in MC, and PC showed less infiltrative growth than MC. In gross type, the most expanding growth pattern was seen in Advanced gastric carcinoma type (AGC) I and the next one was in AGC II; the ratio of infiltrative versus expanding type was highest in AGC IV and next in AGC resembling early gastric carcinoma (EGC) and AGC III in order. On WHO classification except squamous type, all the papillary type showed expanding growth and infiltrative growth was frequently seen in signet-ring cell, undifferentiated, tubular and mucinous types in order. Lymphoid stroma was more frequently found in expanding type than infiltrative type. The frequency of angioinvasion of tumor cells observed was high in AGC resembling EGC, AGC II, III, IV, I and EGC in order. In WHO classification excluding squamous type, undifferentiated and signet-ring cell types occurred more frequently under the age of 60 and papillary type were more frequnetly seen over the age of 60. But tubular type had no difference between the two age groups. In Ming's classification, expanding type was more frequently seen than infiltrative type over the age of 60.
Résumé
No abstract available.