Postoperative biliary stricture is a relatively rare but serious complication of biliary surgery. Although Rouxen-Y hepaticojejunostomy or choledochojejunostomy are well-established and fundamental therapeutic approaches, their postoperative morbidity and mortality rates have been reported to be up to 33% and 13%, respectively. Recent studies suggest that percutaneous transhepatic intervention is an effective and less invasive therapeutic modality compared with traditional surgical treatment. Compared with fluoroscopic intervention, percutaneous with cholangioscopy may be more useful in biliary strictures, as it can provide visual information regarding the stricture site. We recently experienced two cases complete membranous occlusion of the bilioenteric anastomosis and successfully treated both patients using percutaneous transhepatic cholangioscopy.
Choledochostomy ; Cholestasis ; Constriction, Pathologic ; Humans ; Postoperative Complications

We performed original and modified technique of Mays' glanuloplasty in 6 and 12 cases respectively. The results were as follows: 1. 6 cases of mild from of hypospadias (2 cases of coronal, 4 cases of dist. penile) and 12 cases of severe form of hypospadias (5 cases of prox. penile, 6 cases of penoscrotal, 1 case of perineal) on pre-chordectomy but all cases became severe from of hypospadias (2 cases of prox. penile, 15 cases of penoscrotal, 1 case of perineal) on post-chordectomy. 2. The postoperative complications were 3 cases (50.0%) (1 case of meatal stenosis, 2 cases of meatal necrosis) in original technique of Mays' glanuloplasty and 2 cases of meatal stenosis (16.7%) in modified technique of Mays' glanuloplasty.
Constriction, Pathologic ; Female ; Hypospadias* ; Male ; Postoperative Complications

Complications of ureteroneocystostomy are relatively rare. Nevertheless, it would be desirable to use and operative approach that would prevent all complications. Based on our experiences with ureteroneocystostomy during the last 5.6 years, the causes, the operative methods and results were discussed. The results were as follows 1. Ureteroneocystostomy was performed in cases of primary reflux( 7 ureters), megaureter (6), ectopic ureter(5), posterior urethral valve(4) and ureterocele(3) as congenital causes. Acquired causes were iatrogenic ( 7 ureters) , tuberculosis(6), bladder ca(3) and traumatic ureteral injury(2) And causes of remained three ureters couldn`t be seeked. 2. Thirty nine of forty six ureters was performed with the method of submucosal tunnel and 7 with end to side. Among them 11 ureters with diffuse ureteral stricture were combined with the method of Vesico-psoas hitch. 3. Thirty five of thirty eight ureters was successfully corrected. Postoperative complications were contracted VUR in 2 cases, ipsilateral VUR, obstruction and unimproved renal function in each one case.
Constriction, Pathologic ; Postoperative Complications ; Ureter ; Urinary Bladder

PURPOSE: The surgical treatment of anal stenosis includes internal sphincterotomy, rotaton flap and advancement flap according to the stenosis degree, recently, Christensen performed house shaped advancement flap and reported fair results. We compared and analyzed the surgical methods and results in patients with moderate and severe anal stenosis who underwent house shaped advancement flap and C-anoplasty. METHODS: We have performed this study with 6 cases using the house shaped advancement flap and 6 cases using the C-anoplasty. The out come was assessed by clinical characteristics, surgical method, operation time, duration of hospitalization, healing time, postoperative complications, results. RESULTS: The average operation time was 38 min in those house shaped advancement flap cases and 63 min in C-anoplasty cases. The average time of hospitalization was 6 days and 9 days, respectively, and the average time of healing was 28 days and 46 days, respectively. In those house advancement flap cases, surgery could be done in 2 directions at the same time in 4 cases and 3 directions in 2 cases; as for those C-anoplasty cases, surgery could be done in 1 direction in 4 cases and 2 directions in 1 case. Two complications were observed in C-anoplasty, one flap infection and one flap necrosis, and in house shaped advancement flap, no complication was observed. CONCLUSIONS: House shaped advancement flap have several advantages compared to the C-anoplasty, and since house shaped advancement flap could be performed in 2 to 3 directions or even 4 directions at the same time, the anus could sufficiently expanded in severe anal stenosis patients. The house shaped advancement flap might be one of the good method in treating anal stenosis.
Anal Canal ; Constriction, Pathologic* ; Hospitalization ; Humans ; Necrosis ; Postoperative Complications

PURPOSE: We performed this study to evaluate the alterations in renal function for patients with ileal conduit and ileal orthotopic neobladder MATERIALS AND METHODS: From January 1999 to June 2004, 48 patients who had undergone radical cystectomy with urinary diversion were included in our study. The patients were divided into two groups according to the types of urinary diversion. One group consisted of 29 patients with ileal conduit and the other group consisted of 19 patients with ileal W neobladder. The mean age of the ileal conduit group and the ileal W neobladder group were 65.6+/-9.9 years and 60.8+/-8.3 years, respectively. The preoperative and postoperative blood urea nitrogen/creatinine (BUN/Cr) levels, postoperative complications and postoperative GFR, as measured by (99m)Tc-DTPA scans, were compared between the two groups. RESULTS: For the postoperative complications, stricture at the ureterovesical anastomosis site occurred in 1.7% (1/58 renal units) of the ileal conduit group and in 10.5% (4/38 renal units) of the ileal W neobladder group. Acute pyelonephritis occurred in 5.2% (3/58 renal units) of the ileal conduit group and in 5.3% (2/38 renal units) of the ileal W neobladder group. The pre- and postoperative serum BUN/Cr levels were 20.8/1.3 and 24.8/1.6, respectively, in the ileal conduit group, and 17.2/1.1 and 18.8/1.2, respectively, in the ileal W neobladder group. There were no statistical significant differences between the pre- and postoperative changes of the serum BUN/Cr levels for both groups. The GFR, as measured by (99m)Tc-DTPA scans, were 77.6 and 78.7ml/ min/1.73m2 in the ileal conduit group and the ileal W neobladder group, respectively. There were no statistical significant differences between the two groups. CONCLUSIONS: There were no significant differences in renal function between the ileal conduit and ileal W neobladder.
Constriction, Pathologic ; Cystectomy ; Humans ; Postoperative Complications ; Pyelonephritis ; Urea ; Urinary Diversion*

Constriction, Pathologic ; Coronary Angiography ; Coronary Stenosis ; complications ; Coronary Vessels ; Humans ; Syphilis, Cardiovascular ; complications

Laparoscopic colorectal operation is one of the most reliable procedures and widely used in the treatment of gastrointestinal tumor. Its advantages, including minimed invasiveness and rapid postoperative recovery have been widely accepted, but the complications are still chanllenging for surgeons. Intraoperative complications mainly include vascular injury, bowel injury and ureteral damage. Postoperative complications include anastomotic leak, bleeding and stenosis. Understanding of anatomy and precise operation are critical to prevent complications. Diagnosis of postoperative complications in time and proper treatment can achieve maximal improvement of outcomes.
Anastomotic Leak ; Colorectal Surgery ; Constriction, Pathologic ; Humans ; Intraoperative Complications ; Laparoscopy ; Postoperative Complications

Central lung cancer is a common disease in clinic which usually occurs above the segmental bronchus. It is commonly accompanied by bronchial stenosis or obstruction, which can easily lead to atelectasis. Accurately distinguishing lung cancer from atelectasis is important for tumor staging, delineating the radiotherapy target area, and evaluating treatment efficacy. This article reviews domestic and foreign literatures on how to define the boundary between central lung cancer and atelectasis based on multimodal images, aiming to summarize the experiences and propose the prospects.
Humans ; Lung Neoplasms/diagnostic imaging* ; Pulmonary Atelectasis/complications* ; Bronchi ; Constriction, Pathologic/complications* ; Multimodal Imaging

BACKGROUND: The treatment of intrahepatic stones is difficult because of frequent recurrence and residual stones. There are several suggested methods of treatment which include surgical bile-uct exploration with or without biliary drainage, an endoscopic procedure, transhepatic cholangiolithotomy, and hepatic resection. METHODS: We reviewed the therapeutic results in 96 patients who had hepatolithiasis and received surgery at Soon Chun Hyang University Chunan Hospital during the 10 years from June 1987 to June 1997. We divided them into 2 groups: one was the group of patients receiving a hepatic resection with or without a drainage procedure (resection group), and the other was the group of patients receiving only a T-ube choledochostomy or drainage procedure (nonresection group). RESULTS: The male-to-female ratio was 1:1.74, and the most prevalent age group was the 5th decade (31.3%). The most common symptoms were epigastric pain (61%) and RUQ pain (60%), and the locations of stones were the right intrahepatic duct in 10 cases (10.4%), the left intrahepatic duct in 47 cases (49%), and both intrahepatic duct in 39 cases (40.6%). Operative methods were a resection in 29 cases and a nonresection in 67 cases. The incidence of residual stones were 31.0% in the hepatic resection group and 68.6% in the nonresection group. The postoperative complication rate was 20.6% in hepatic resection group and 38.8% in the nonresection group, and the follow-p study showed the good results (Good & Fair) for 92.5% of the hepatic resection group and 66.7% of the nonresection group. CONCLUSION: The hepatic resection with or without drainage is an adequate treatment for hepatolithiasis. It can eradicate localized intrahepatic calculi, irreversible biliary stricture, an atrophied segment, and, possibly, an associated cholangiocarcinoma, with good results in clinical evaluation.
Calculi ; Cholangiocarcinoma ; Choledochostomy ; Chungcheongnam-do ; Constriction, Pathologic ; Drainage ; Humans ; Incidence ; Postoperative Complications ; Recurrence

PURPOSE: After the excision of a choledochal cyst, late complications seldom develop. Herein, we propose a modified surgical classification, which allows surgeons to select an appropriate operation and minimize late postoperative complications. METHODS: A total of 90 Todani type I and IV cases were reviewed to examine the morphologic characteristics of choledochal cysts and to evaluate the clinical outcomes after cyst excision. The cysts were then reclassified based on factors determining the postoperative outcomes. RESULTS: There were 8 intrahepatic complications (4 cholangitis, 4 IHD stones) and 3 intrapancreatic complications (2 pancreatitis, 1 symptomatic remnant distal cyst). Seven of the 8 intrahepatic complications (87.5%) occurred in cases with IHD dilatation, 6 of which were associated with a ductal stricture or isolated intrahepatic cyst. Using the above factors as classification criteria, a modified surgical classification is proposed. Cases were classified as types I or IV cysts according to the presence of IHD dilatation. The type I cysts were further divided into types Ia and Ib according to the cyst multiplicity, and type IV cysts according to the pattern of continuity between the extra- and intrahepatic cyst: IHD dilatation without stricture, IVa; IHD dilatation with ductal stricture, IVb; isolated intrahepatic cyst, IVc. CONCLUSION: According to our classification, the extrahepatic approach is enough for types I, IVa and IVb to improve long-term outcome. For type IVc and some of type IVb with a stricture, where an extrahepatic approach is difficult, and hepatectomy should be combined.
Cholangitis ; Choledochal Cyst* ; Classification* ; Constriction, Pathologic ; Dilatation ; Hepatectomy ; Pancreatitis ; Postoperative Complications