Korean journal of hepato-biliary-pancreatic surgery最新文献_第4页

In vitro immune cell monitoring as a guide for long-term immunosuppression in adult liver transplant recipients 体外免疫细胞监测对成人肝移植受者长期免疫抑制的指导作用

Korean journal of hepato-biliary-pancreatic surgery Pub Date : 2015-11-01 DOI: 10.14701/kjhbps.2015.19.4.139

Eun-Kyoung Jwa, Shin Hwang, Y. Kwon, Nayoung Kim, G. Song, D. Jung, C. Ahn, E. Tak, D. Moon, Ki‐Hun Kim, T. Ha, G. Park, Sung‐Gyu Lee

{"title":"In vitro immune cell monitoring as a guide for long-term immunosuppression in adult liver transplant recipients","authors":"Eun-Kyoung Jwa, Shin Hwang, Y. Kwon, Nayoung Kim, G. Song, D. Jung, C. Ahn, E. Tak, D. Moon, Ki‐Hun Kim, T. Ha, G. Park, Sung‐Gyu Lee","doi":"10.14701/kjhbps.2015.19.4.139","DOIUrl":"https://doi.org/10.14701/kjhbps.2015.19.4.139","url":null,"abstract":"Backgrounds/Aims We evaluated the clinical usability of immune cell monitoring in adult liver transplantation (LT) recipients. Methods This study was composed of two parts as using calcineurin phosphatase (CNP) activity assay and ImmuKnow assay independently as in vitro monitoring tools of immune cell function in adult LT recipients. Results There was a rough correlation between CNP activity and tacrolimus concentration in 33 patients. This association was evident in patients who were only administered tacrolimus, but disappeared after the co-administration of mycophenolate. In 118 healthy individuals, the mean proportion of helper T-cells was 37.4±8.1%. According to ImmuKnow assay, their immune responses were strong in 12 patients (10.2%), moderate in 92 patients (78.0%), and low in 14 patients (11.9%). In 85 patients waiting for LT, there was a rough correlation between the ImmuKnow ATP level and age. Their immune responses were strong in 0 patients (0%), moderate in 8 patients (9.4%), and low in 77 patients (90.6%). There was a difference in the ImmuKnow ATP levels between healthy individuals and patients with liver disease. In 137 LT recipients, there was no correlation between the ImmuKnow ATP levels and tacrolimus concentration. This trend did not change after grouping the patients according to co-administration with mycophenolate. Eight recipients experienced acute rejection, but none showed strong immune response. Conclusions We think that both CNP activity assay and ImmuKnow assay are too limited to objectively determine the level of immunosuppression. Further studies should be performed to identify other methods for immune function monitoring.","PeriodicalId":91136,"journal":{"name":"Korean journal of hepato-biliary-pancreatic surgery","volume":"19 1","pages":"139 - 148"},"PeriodicalIF":0.0,"publicationDate":"2015-11-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://sci-hub-pdf.com/10.14701/kjhbps.2015.19.4.139","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"66890153","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

引用次数: 5

Clinical outcomes in surgical and non-surgical management of hepatic portal venous gas 肝门静脉气体手术与非手术治疗的临床效果

Korean journal of hepato-biliary-pancreatic surgery Pub Date : 2015-11-01 DOI: 10.14701/kjhbps.2015.19.4.181

Soo-kyung Yoo, Jong-hoon Park, S. Kwon

{"title":"Clinical outcomes in surgical and non-surgical management of hepatic portal venous gas","authors":"Soo-kyung Yoo, Jong-hoon Park, S. Kwon","doi":"10.14701/kjhbps.2015.19.4.181","DOIUrl":"https://doi.org/10.14701/kjhbps.2015.19.4.181","url":null,"abstract":"Backgrounds/Aims Hepatic portal venous gas (HPVG) is a rare condition, with poor prognosis and a mortality rate of up to 75%. Indications for surgical and non-surgical management of HPVG including associated complications and mortality remain to be clarified. Methods From January 2008 to December 2014, 18 patients with HPVG diagnosed through abdominal computed tomography (CT) imaging were retrospectively identified. Clinical symptoms, laboratory data, underlying diseases, treatment, and mortality rate were analyzed. Patients were classified into 2 groups: surgical management recommended (SR, n=10) and conservative management (CM, n=8). The SR group was further subdivided into patients who underwent surgical management (SM-SR, n=5) and those who were managed conservatively (NS-SR, n=5). Results Conditions underlying HPVG included mesenteric ischemia (38.9%), intestinal obstruction (22.2%), enteritis (22.2%), duodenal ulcer perforation (5.6%), necrotizing pancreatitis (5.6%), and diverticulitis (5.6%). In terms of mortality, 2 patients (40%) died in the SM-SR group, 1 (12.5%) in the CM group, and 100% in the NS-SR group. Higher scores from Acute Physiology and Chronic Health Evaluation (APACHE) II predicted the mortality rates of the NS-SR and CM groups. Conclusions Identification of HPVG requires careful consideration for surgical management. If surgical management is indicated, prompt laparotomy should be performed. However, even in the non-surgical management condition, aggressive laparotomy can improve survival rates for patients with high APACHE II scores.","PeriodicalId":91136,"journal":{"name":"Korean journal of hepato-biliary-pancreatic surgery","volume":"19 1","pages":"181 - 187"},"PeriodicalIF":0.0,"publicationDate":"2015-11-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://sci-hub-pdf.com/10.14701/kjhbps.2015.19.4.181","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"66889992","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

引用次数: 14

Comparison of survival outcomes after anatomical resection and non-anatomical resection in patients with hepatocellular carcinoma 肝细胞癌解剖切除与非解剖切除的生存结果比较

Korean journal of hepato-biliary-pancreatic surgery Pub Date : 2015-11-01 DOI: 10.14701/kjhbps.2015.19.4.161

Seheon Kim, Seokwhan Kim, I. Song, Kwang-Sik Chun

{"title":"Comparison of survival outcomes after anatomical resection and non-anatomical resection in patients with hepatocellular carcinoma","authors":"Seheon Kim, Seokwhan Kim, I. Song, Kwang-Sik Chun","doi":"10.14701/kjhbps.2015.19.4.161","DOIUrl":"https://doi.org/10.14701/kjhbps.2015.19.4.161","url":null,"abstract":"Backgrounds/Aims Liver resection is a curative procedure performed worldwide for hepatocellular carcinoma (HCC). Deciding on the appropriate resection range for postoperative hepatic function preservation is an important surgical consideration. This study compares survival outcomes of HCC patients who underwent anatomical or non-anatomical resection, to determine which offers the best clinical survival benefit. Methods One hundred and thirty-one patients underwent liver resection with HCC, between January 2007 and February 2015, and were divided into two groups: those who underwent anatomical liver resection (n=88) and those who underwent non-anatomical liver resection (n=43). Kaplan-Meier survival analysis and Cox regressions were used to compare the disease-free survival (DFS) and overall survival (OS) rates between the groups. Results The mean follow-up periods were 27 and 40 months in the anatomical and non-anatomical groups, respectively (p=0.229). The 3- and 5-year DFS rates were 70% and 60% in the anatomical group and 62% and 48% in the non-anatomical group, respectively. The 3 and 5-year OS rates were 94% and 78% in the anatomical group, and 86% and 80% in the non-anatomical group, respectively. The anatomical group tended to show better outcomes, but the findings were not significant. However, a relative risk of OS between the anatomical and non-anatomical group was 0.234 (95% CI, 0.061-0.896; p=0.034), which is statistically significant. Conclusions Although statistical significance was not detected in survival curves, anatomical resection showed better results. In this respect, anatomical resection is more likely to perform in HCC patients with preserve liver function than non-anatomical resection.","PeriodicalId":91136,"journal":{"name":"Korean journal of hepato-biliary-pancreatic surgery","volume":"19 1","pages":"161 - 166"},"PeriodicalIF":0.0,"publicationDate":"2015-11-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://sci-hub-pdf.com/10.14701/kjhbps.2015.19.4.161","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"66890337","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

引用次数: 10

Fatigue and related factors after liver transplantation 肝移植术后疲劳及相关因素分析

Korean journal of hepato-biliary-pancreatic surgery Pub Date : 2015-11-01 DOI: 10.14701/kjhbps.2015.19.4.149

K. Hong, Hyeyoung Kim, Jeong‐Moo Lee, Kwang-Wonng Lee, N. Yi, Hae Won Lee, Y. Choi, S. Suh, S. Hong, K. Yoon, Hyo-Sin Kim, K. Suh

{"title":"Fatigue and related factors after liver transplantation","authors":"K. Hong, Hyeyoung Kim, Jeong‐Moo Lee, Kwang-Wonng Lee, N. Yi, Hae Won Lee, Y. Choi, S. Suh, S. Hong, K. Yoon, Hyo-Sin Kim, K. Suh","doi":"10.14701/kjhbps.2015.19.4.149","DOIUrl":"https://doi.org/10.14701/kjhbps.2015.19.4.149","url":null,"abstract":"Backgrounds/Aims Fatigue is common in chronic hepatitis and end-stage liver disease. However, little is known about fatigue after liver transplantation (LT). We therefore evaluated the prevalence, severity, and related factors of fatigue after LT. Methods We retrospectively reviewed adult recipients who responded to our survey at outpatient clinics between April and May 2013. Fatigue and its severity were assessed using a questionnaire with the Fatigue Severity Scale (FSS). We defined fatigue as FSS of 4.0 or more and severe fatigue as FSS of 5.1 or more. The related factors including hepatocellular carcinoma and complications were analyzed. Results A total of 93 patients were included in this study. The mean age was 54.9 (19-76) years and two-thirds were men (67.7%). Living donor LT was 77.4%. Hepatitis B related liver disease was the main underlying disease (77.4%), with hepatocellular carcinoma accompanied in 33.3%. The mean follow-up period was 66.8±43.2 (2-171) months. The mean FFS was 2.83±1.48 (1.0-6.7) overall and 5.10±0.82 (4.0-6.7) in the fatigue group. Of the 93 adult patients, fatigue was presented in 20 patients (21.5%). Among these, 9 patients (45.0%) showed severe fatigue. Even though post-LT complications tended to be greater in the fatigue group (50.0% vs. 30.1% in the non-fatigue group, p=0.098), there were no significant related factors of fatigue after LT, including hepatocellular carcinoma and major complication. Conclusions Fatigue is present in a considerable portion of recipients after LT, and almost half of them have severe fatigue. Further efforts are needed to decrease fatigue in LT recipients.","PeriodicalId":91136,"journal":{"name":"Korean journal of hepato-biliary-pancreatic surgery","volume":"19 1","pages":"149 - 153"},"PeriodicalIF":0.0,"publicationDate":"2015-11-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://sci-hub-pdf.com/10.14701/kjhbps.2015.19.4.149","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"66890205","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

引用次数: 8

Erratum: Therapeutic induction of hepatic atrophy for isolated injury of the right anterior sectoral duct following laparoscopic cholecystectomy 误注:腹腔镜胆囊切除术后右前段胆管孤立性损伤的肝萎缩诱导治疗

Korean journal of hepato-biliary-pancreatic surgery Pub Date : 2015-11-01 DOI: 10.14701/kjhbps.2015.19.4.194

Shin Hwang, Sam-Youl Yoon, Sung-Won Jung, J. Namgoong, G. Park, D. Gwon, Sung‐Gyu Lee

引用次数: 0

Comparative analysis of intraoperative radiofrequency ablation versus non-anatomical hepatic resection for small hepatocellular carcinoma: short-term result 术中射频消融与非解剖性肝切除术治疗小肝癌的近期疗效比较分析

Korean journal of hepato-biliary-pancreatic surgery Pub Date : 2015-11-01 DOI: 10.14701/kjhbps.2015.19.4.173

Y. Yune, Seokwhan Kim, I. Song, Kwang-Sik Chun

{"title":"Comparative analysis of intraoperative radiofrequency ablation versus non-anatomical hepatic resection for small hepatocellular carcinoma: short-term result","authors":"Y. Yune, Seokwhan Kim, I. Song, Kwang-Sik Chun","doi":"10.14701/kjhbps.2015.19.4.173","DOIUrl":"https://doi.org/10.14701/kjhbps.2015.19.4.173","url":null,"abstract":"Backgrounds/Aims To compare the clinical outcomes of intraoperative radiofrequency ablation (RFA) and non-anatomical hepatic resection (NAHR) for small hepatocellular carcinoma (HCC). Methods From February 2007 to January 2015, clinical outcomes of thirty four patients with HCC receiving RFA or NAHR were compared, retrospectively. Results There was no difference of patient and tumor characteristic between the two groups that received RFA or NAHR. The 1, 2, and 3-year recurrence rates following RFA were 32.2%, 32.2% and 59.3% respectively, and 6.7%, 33.3% and 33.3% following NAHR respectively (p=0.287). The 1, 2 and 3-year overall survival (OS) rates following RFA were 100%, 88.9% and 76.2% respectively, and 100%, 85.6% and 85.6%, respectively, following NAHR (p=0.869). We did not find a definite statistical difference in recurrence rate and OS rate between the two groups. In the multivariate analysis, number of tumor was an independent prognostic factor for recurrence and albumin was an independent prognostic factor for OS. Conclusions We recommend non-anatomical hepatic resection rather than intraoperative RFA in small sized HCC, due to a higher recurrence rate in intraoperative RFA. Intraoperative RFA was inferior to non-anatomical hepatic resection in terms of recurrence rate. We need to select the optimal treatment considering liver function and possibility of recurrence.","PeriodicalId":91136,"journal":{"name":"Korean journal of hepato-biliary-pancreatic surgery","volume":"19 1","pages":"173 - 180"},"PeriodicalIF":0.0,"publicationDate":"2015-11-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://sci-hub-pdf.com/10.14701/kjhbps.2015.19.4.173","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"66890444","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

引用次数: 8

Bile duct invasion can be an independent prognostic factor in early stage hepatocellular carcinoma 胆管侵犯是早期肝细胞癌的独立预后因素

Korean journal of hepato-biliary-pancreatic surgery Pub Date : 2015-11-01 DOI: 10.14701/kjhbps.2015.19.4.167

Y. Jang, Kwang-Wonng Lee, Hyeyoung Kim, Jeong‐Moo Lee, N. Yi, K. Suh

{"title":"Bile duct invasion can be an independent prognostic factor in early stage hepatocellular carcinoma","authors":"Y. Jang, Kwang-Wonng Lee, Hyeyoung Kim, Jeong‐Moo Lee, N. Yi, K. Suh","doi":"10.14701/kjhbps.2015.19.4.167","DOIUrl":"https://doi.org/10.14701/kjhbps.2015.19.4.167","url":null,"abstract":"Backgrounds/Aims In hepatocellular carcinoma (HCC), bile duct invasion occurs far more rarely than vascular invasion and is not well characterized. In addition, the pathologic finding of bile duct invasion is not considered an independent prognostic factor for HCC following surgery. In this study, we determined the characteristics of HCC with bile duct invasion, and assessed the clinical significance of bile duct invasion. Methods We retrospectively reviewed the medical records of 363 patients who underwent hepatic resection for HCC at Seoul National University Hospital (SNUH) from January 2009 to December 2011. Preoperative, operative, and pathological data were collected. The risk factors for recurrence and survival were analyzed. Subsequently, the patients were divided into 2 groups according to disease stage (American Joint Committee on Cancer/International Union Against Cancer 7th edition): early stage (T1 and 2) and advanced stage (T3 and 4) group; and risk factors in the sub-groups were analyzed. Results Among 363 patients, 13 showed bile duct invasion on pathology. Patients with bile duct invasion had higher preoperative total bilirubin levels, greater microvascular invasion, and a higher death rate than those without bile duct invasion. In multivariate analysis, bile duct invasion was not an independent prognostic factor for survival for the entire cohort, but, was an independent prognostic factor for early stage. Conclusions Bile duct invasion accompanied microvascular invasion in most cases, and could be used as an independent prognostic factor for survival especially in early stage HCC (T1 and T2).","PeriodicalId":91136,"journal":{"name":"Korean journal of hepato-biliary-pancreatic surgery","volume":"19 1","pages":"167 - 172"},"PeriodicalIF":0.0,"publicationDate":"2015-11-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://sci-hub-pdf.com/10.14701/kjhbps.2015.19.4.167","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"66890358","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

引用次数: 9

Hepatectomy, combined with intraoperative radiofrequency ablation in patients with multiple hepatocellular carcinomas. 肝切除术联合术中射频消融术治疗多发性肝细胞癌。

Korean journal of hepato-biliary-pancreatic surgery Pub Date : 2015-08-01 Epub Date: 2015-08-28 DOI: 10.14701/kjhbps.2015.19.3.98

Seok Joon Lee, Eung-Ho Cho, Ryounggo Kim, Young Han Kim, Chang-Sup Lim, Sang Bum Kim

{"title":"Hepatectomy, combined with intraoperative radiofrequency ablation in patients with multiple hepatocellular carcinomas.","authors":"Seok Joon Lee, Eung-Ho Cho, Ryounggo Kim, Young Han Kim, Chang-Sup Lim, Sang Bum Kim","doi":"10.14701/kjhbps.2015.19.3.98","DOIUrl":"https://doi.org/10.14701/kjhbps.2015.19.3.98","url":null,"abstract":"Backgrounds/aims: We compared the efficacy and safety of a hepatectomy, combined with intraoperative radiofrequency ablation to those of wider extent hepatectomy, alone, in patients with multiple hepatocellular carcinomas (HCCs).Methods: Between January 2004 and December 2013, 78 patients with multiple HCCs underwent surgery. 25 patients were treated by hepatectomy, combined with intraoperative radiofrequency ablation (RFA) (group A), and 53 underwent hepatectomy only (group B). We retrospectively analyzed medical records to compare the clinical features of these two groups.Results: Patients in group A had more limited resections (less than 2 segments) than those in group B (p<0.001). Patients in group A also tended to have fewer red blood cell transfusions than those in group B (p=0.060). Liver function- and surgery-related complications occurred only in group B. There were no in-hospital mortalities in both groups. The overall survival and disease-free survival outcomes were not significantly different between groups A and B (p=0.177 and p=0.305, respectively).Conclusions: Hepatectomy combined with intraoperative RFA could be a safe and effective treatment option for patients with multiple HCCs, comparable to extended hepatectomy alone.","PeriodicalId":91136,"journal":{"name":"Korean journal of hepato-biliary-pancreatic surgery","volume":"19 3","pages":"98-102"},"PeriodicalIF":0.0,"publicationDate":"2015-08-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://sci-hub-pdf.com/10.14701/kjhbps.2015.19.3.98","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"34013918","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

引用次数: 14

A case of gallbladder cancer combined with ectopic individual opening of pancreatic and bile ducts to the duodenal bulb. 胆囊癌合并个别胰胆管通往十二指肠球的异位开口1例。

Korean journal of hepato-biliary-pancreatic surgery Pub Date : 2015-08-01 Epub Date: 2015-08-28 DOI: 10.14701/kjhbps.2015.19.3.121

Woohyung Lee, Ji-Ho Park, Ju-Yeon Kim, Seung-Jin Kwag, Taejin Park, Sang-Ho Jeong, Young-Tae Ju, Eun-Jung Jung, Young-Joon Lee, Sang-Kyung Choi, Soon-Chan Hong, Chi-Young Jeong

{"title":"A case of gallbladder cancer combined with ectopic individual opening of pancreatic and bile ducts to the duodenal bulb.","authors":"Woohyung Lee, Ji-Ho Park, Ju-Yeon Kim, Seung-Jin Kwag, Taejin Park, Sang-Ho Jeong, Young-Tae Ju, Eun-Jung Jung, Young-Joon Lee, Sang-Kyung Choi, Soon-Chan Hong, Chi-Young Jeong","doi":"10.14701/kjhbps.2015.19.3.121","DOIUrl":"https://doi.org/10.14701/kjhbps.2015.19.3.121","url":null,"abstract":"Ectopic opening of the pancreatic and bile ducts (EOPBD) into the duodenal bulb is an extremely rare congenital anomaly with unknown clinical implications. We presented a case of gallbladder cancer with EOPBD into the duodenal bulb. A 57-year-old male was referred to our hospital with intermittent right upper abdominal pain. Endoscopic retrograde cholangiopancreatography and magnetic resonance cholangiopancreatography showed individual EOPBD into the duodenal bulb with no papillary structure, and a focal nodular lesion in the gallbladder. A follow-up abdominal computed tomography scan 9 months later revealed a slight increase in the size of the fundal nodule, which was suspected as gallbladder cancer. An intraoperative frozen biopsy identified the nodular lesion as adenocarcinoma involving the cystic duct, and the patient underwent radical cholecystectomy including bile duct resection with hepaticojejunostomy. EOPBD is an extremely rare condition that can be associated with gallbladder malignancy as well as benign disease. Clinicians should follow up carefully and consider surgical treatment for suspected malignant lesions. ","PeriodicalId":91136,"journal":{"name":"Korean journal of hepato-biliary-pancreatic surgery","volume":"19 3","pages":"121-4"},"PeriodicalIF":0.0,"publicationDate":"2015-08-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://sci-hub-pdf.com/10.14701/kjhbps.2015.19.3.121","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"34079604","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

引用次数: 2

Comparison between operative versus non-operative management of traumatic liver injury. 外伤性肝损伤手术与非手术治疗的比较。

Korean journal of hepato-biliary-pancreatic surgery Pub Date : 2015-08-01 Epub Date: 2015-08-28 DOI: 10.14701/kjhbps.2015.19.3.103

Ki Bum Park, Dong Do You, Tae Ho Hong, Jung Min Heo, Yong Sung Won

{"title":"Comparison between operative versus non-operative management of traumatic liver injury.","authors":"Ki Bum Park, Dong Do You, Tae Ho Hong, Jung Min Heo, Yong Sung Won","doi":"10.14701/kjhbps.2015.19.3.103","DOIUrl":"https://doi.org/10.14701/kjhbps.2015.19.3.103","url":null,"abstract":"Backgrounds/aims: The aim of this study was to compare operative versus non-operative management of patients with liver injury and to ascertain the differences of the clinical features.Methods: From April 2000 to July 2012, 191 patients were admitted to Seoul St. Mary's Hospital and St. Vincent's Hospital for liver injuries. Of these, 148 patients were included in this study. All patients were diagnosed using computed tomography (CT). The liver injury was graded in accordance with the American Association for the Surgery of Trauma liver injury scoring scale. Patients were divided into two groups: those who underwent surgery and those treated with non-operative management (NOM). There was a comparison between these two groups concerning the clinical characteristics, grade of liver injury, hemodynamic stability, laboratory findings, and mortality.Results: According to the 148 patient records evaluated, 108 (72.9%) patients were treated with NOM, and 40 (27.1%) underwent surgery. Patients treated with NOM had significantly fewer severe injuries as rated using the Revised Traumatic Injury Scale, Injury Severity Score, and Glasgow Coma Scale. Grade of liver injury and number of patients with extravasation of contrast dye on CT and hemoperitoneum were higher in the operative group than in the NOM group. There were significant differences between the two groups for: heart rate, respiratory rate, systolic blood pressure, and mean hemoglobin levels at admission and after 4 hours. The operative group experienced a significantly higher mortality than the NOM group.Conclusions: The results of our study suggest that hemodynamic stability and the following should be considered for deciding the treatment for liver injuries: grade of liver injury, amount of blood loss, and injury scales scores.","PeriodicalId":91136,"journal":{"name":"Korean journal of hepato-biliary-pancreatic surgery","volume":"19 3","pages":"103-8"},"PeriodicalIF":0.0,"publicationDate":"2015-08-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://sci-hub-pdf.com/10.14701/kjhbps.2015.19.3.103","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"34013919","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

引用次数: 8