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수술후 出現한 황달에 관한 관찰 The Postoperative jaundice

대한외과학회지 1972년 14권 5호 p.7 ~ 12
金炯泰, 金聖哲,
소속 상세정보
金炯泰 (  ) 
聖心病院 外科

金聖哲 (  ) 
聖心病院 外科

Abstract


This report is our experience of 5 cases of postoperative jaundice at Sacred Heart Hospital during
3 years periods from June, 1968 to August, 1971 and a review of the literature in regard to the cause
and mechanism. (During the same period) 1821 operations were undertaken under the endotracheal general
anesthesia in surgical department .
Diseases of the liver and biliary tract which may cause the jaundice in postoperative period were
excluded. The incidence of the postoperative jaundice is rare.
In general, the jaundice is classified into prehepatic jaundice, hepatic jaundice and posthepatic jaundice.
But postoperative jaundice is difficult to classify due to incomplete confirmation of the mechanism of
the jaundice.
It is said that the causes of the postoperative jaundice are hyperhemolysis following massive trans
fusion of the old blood, hepatotoxic effect of certain anesthetic drugs, the use of certain drugs including
antibiotics, arsenic compound, quinoline deriavatives arsenobenzol derivatives, organic and inorganic com
pound and poor general conditions such as shock state, hypoxic condition, congestive heart failure.
respiratory failure and renal failure.
But, as yet the complete mechanism and cause of the postoperative jaundice are remained unknown.
These 5 cases of postoperative jaundice are consisted of patient of appendectomy for appendicitis,
appendectomy and drainage for perforated appendicitis, subtotal gastrectomy for duodenal ulcer perfora
tion, adhesiotomy for intestinal strangulation following subtotal gastrectomy for pyloric obstruction
caused by duodenal ulcer, right hemicolectomy and abscess drainage operation for intra-abdominal
abscess and mesenteric abscess.
1. The sex of our cases were all male.
2. The time of development of the jaundice was postoperative 1st and 2nd day.
3. The degree of jaundice was from 2.4㎎% to 14.2㎎% in serum bilirubin level and there was
no difference between the conjugated bilirubin and unconjugated bilirubin by Van den Berg reation.
4. The hepatomegaly, splenomegaly ann itching sensation were absent.
5. The jaundice was disappeared spontaneously from postoperative 7th day to 21st day.
6. The prognosis was good without death in conrast to other reports.

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