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廣範圍小腸切除에 關한 臨床的 考察 Clinical evaluation of the extensive resection of the small intestine

대한외과학회지 1972년 14권 2호 p.57 ~ 61
兪明鍾, 金一煥, 秦柄鎬,
소속 상세정보
兪明鍾 (  ) 
서울대학교 醫科大學 外科學敎室

金一煥 (  ) 
국립경찰병원 일반외과
秦柄鎬 (  ) 
서울대학교 醫科大學 外科學敎室

Abstract


Removal of a large part of the small intestine is not undertaken lightly because of the ill effects on
nutrition which may ensue. Occasionally, however, such resections cannot be avoided when the surgeon
is faced with severe extensive disease of the intestine. The terms "massive" or "extensive" resection of
small intestine generally implies removal of more than 200㎝ or one third of its total length. The
minimal length of small intestine necesary for a tolerable life is a general view todat that two thirds
of the small intestine may be resected without untoward sequelae.
The purpose of this paper is to evaluate clinical status in a series of patients following massive res
cation of the small intestine.
During the period from January, 1963, to July, 1970, thirteen underwent massive resection of the
small intestine at the National Seoul University Hospital and National Police Hospital.
The thirteen patients one divided into two groups according to the type of resection : GroupⅠ, partial
resection of the jejunum and ileum : Group Ⅱ, partial resection of the jejunum and ileum including
cecum and ascending colon.
Following such extensive resection several changes take place. The remaining gut undergoes conside
racle hypertrophy-including the villi and the remaining part of the small intestine elongates. The gastric
secreation increase and the emptying of the stomach becomes delayed.
The matacolic studies following extensive small intestine resectiong will always be increased loss of
fat, water, proteins and electrolytes in the feces.
A few patients were developed hypocalemia and tetany. The most frequent cause of death were
malnutrition and deaths usually occurs three to twelve months after operation.

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