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담낭절제술후 증후군에 대한 임상적 고찰 A Clinicl Study on Postcholecy-tectomy Syndrome

대한외과학회지 1975년 17권 2호 p.17 ~ 28
김창헌,
소속 상세정보
김창헌 (  ) 
국립의료원 일반외과

Abstract


The clinically study on postcholecystectomy syndrome.
The postcholecystectomy syndrome is clinically one of main problems in the biliary surgery and the incidence of it is known as high.
In the biliary lesions in Korea, the location of stones are definitely different from that of western people.
For the purpose to evaluate the incidence of postcholecystectomy syndrome and the correlation between this syndrome and the operative procedure, state of cholecystitis, location of stones and values of serum bilrubin and alkaline phosphatase measured at the time of previous operations, author has done this study in 480 cases, who treated at surgical department of National Medical Center, from Jan. 1973.
The results were as follows:
1. The incidence of "severe" postcholecystectomy syndrome was 11.9% (57 cases) and out of these, the causes due to calculus was 47.1% (27/57 cases), peptic ulcer 10. 5%, chronic pancrea-titis 10.5%, diverticulitis 3.5% respectively.
2. In the distribution of age, 68% (324 cases) was in the age from 31 to 60, the youngest was 16 and the oldest 64. The ratio of sex incidence, female to male was 1.3: 1.
3. The incidence of "severe" postcholecystectomy syndrome from acute cholecystitis was 14.7% (13/129 cases) and that from chronic cholecystitis was 10.8% (39/351 cases).
4. The incidence of "severe" postcholecystectomy syndrome from calculous cases in previous operations was 12.2%(44/362 cases), and that from non calculous one was 11.0%(13/118 cases).
5. The incidence of "severe" postcholecystectomy syndrome from cases of CBD explorations was 15.8% (41/258 cases) with a little high incidence in calculous cases, 16.6% (35/205) com-paring to non calculous one, 11. 3% (6/53). That from cholecystectomy, only, was 4.4% (6/135 cases).
6. In the incidence of P.C.S. related to stone locations at 1st operations, the severe postcho lecystectomy syndrome from CBD stones was 10.3%(15/146) and that from IHD stone was 42.5%
(17/40). But that from GB stone only, was 4.2%. (5/120).
7. In the sites of stones in postcholecystectomy syndrome, 40.0% (90 cases) was in common bile duct, 24.0% (54 cases) in GB only, 1.7% (4 cases) in IHD only respectively,
8. In the time intervals which occur the "severe" postcholocystectoany syndrome, 80.7% (46/57 cases) was in the length from 3 months to 3 years.
9. There were no significant relationships between serum bilirubin and alkaline phosphatase
measured at the time of previous operations and the incidence of "severe" postcholecystectcrny syndrome.

10. In "severe" PCS, the cured cases in operated one was 62.5% (15/24 cases), that in non-operated one was 15.2% (15/33 cases).

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