PURPOSE: The aim of this study is to examine whether conventional primary closure of the bile duct without routinely inserting a T-tube could be performed after all the surgeries used to treat choldocholithiasis. METHODS: From April 2002 to July 2005, we retrospectively analyzed 125 bile duct stone disease patients who underwent primary closure of the bile duct. RESULTS: Wound infection was the most frequent surgical complications, and it showed a higher trend in the patients who had a history of previous biliary operation, and it showed a trend to be slightly higher in the recurrent biliary stone cases than that in the de novo cases. However, these findings were not statistically significant. In addition, surgical complications developed in 16 of 100 patients who were older that 60 years, whereas there was only 1 of 25 patients who developed complications for the patients younger than 60 years. The development of complications has a tendency to be higher for the older patients, yet the level was not statistically significant. In regard to postsurgical hyperamylasemia, although a statistically significant difference could not be detected, this malady developed in 3 of 12 cases in whom endoscopic nasobiliary drainage (ENBD) tubes were inserted. This showed a trend to be higher than that for 13 cases of 113 patients for whom endoscopic nasobiliary drainage tubes were not inserted. Concerning the postsurgical hospitalization period, it was significantly longer in the cases who developed complications (p=0.018), and there was a tendency for a prolonged hospitalization period for the patients who were older than 60 years, for women, recurrent cases and the cases with a history of the bile duct surgery. Yet these had no statistical significance CONCLUSION: It appears that the primary closure of bile duct is a technique that could be performed safely for all choledocolithotomy patients , and this is regardless of the size of bile duct diameter, history of surgery on the bile duct system, gender, emergency operation, age, recurrent biliary stones, the presence of presurgical nasobiliary drainage tube and the presence of concomitant diseases.
Bile Ducts* ; Bile* ; Choledocholithiasis ; Drainage ; Emergencies ; Female ; Hospitalization ; Humans ; Hyperamylasemia ; Length of Stay ; Retrospective Studies ; Wound Infection

Acinetobacter baumannii is the most abundunt species of the Acinetobacter genus. The incidence of bacteremia caused by Acinetobacter baumannii among bloodstream infection has been increasing since 1986, when the taxonomy of the genus was first described. The mortality rate of bacteremia due to Acinetobacter baumannii is high, with reported ranging from 17 to 52%. We report a case of septic shock due to Acinetobacter baumannii in a 54-year-old man who underwent subtotal gastrectomy, with Billroth II reconstruction, for stomach cancer.
Acinetobacter baumannii* ; Acinetobacter* ; Bacteremia ; Classification ; Gastrectomy ; Gastroenterostomy ; Humans ; Incidence ; Middle Aged ; Mortality ; Shock, Septic* ; Stomach Neoplasms

PURPOSE: Circular stapled hemorrhoidopexy (CSH) is widely used to treat patients with grades III–IV hemorrhoids because of less pain and short hospital stay. However, this procedure is associated with some complications, such as urge to defecate, anal stenosis, staple line dehiscence, abscess and sepsis. To avoid these complications, surgeons perform a partial stapled hemorrhoidopexy (PSH). The aim of this study is to present our early experience with the PSH. METHODS: We retrospectively reviewed the medical records of 58 patients with hemorrhoids who were treated with a PSH at Busan Hang-Un Hospital from January 2016 to June 2016. A specially designed tri-window anoscope was used, and a purse string suture was made at the mucosae of the protruding hemorrhoids through the window of the anoscope. The hemorrhoidopexy was done by using a circular stapler. RESULTS: Of the 58 patients included in this study, 34 were male and 24 were female patients (mean age, 50.4 years). The mean operation time was 12.4 minutes, and the mean postoperative hospital stay was 3.8 days. Three patients experienced bleeding (5.1%) 5 urinary retention (8.6%) and 5 skin tags (8.6%). Urge to defecate, tenesmus, abscess, rectovaginal fistula, anal stricture, incontinence, and recurrence did not occur. CONCLUSION: PSH is a minimally invasive, feasible, and safe technique for treating patients with grades III–IV hemorrhoids. A PSH, instead of a CSH, can be used to treat certain patients with hemorrhoids.
Abscess ; Busan ; Constriction, Pathologic ; Female ; Hemorrhage ; Hemorrhoids* ; Humans ; Length of Stay ; Male ; Medical Records ; Mucous Membrane ; Rectovaginal Fistula ; Recurrence ; Retrospective Studies ; Sepsis ; Skin ; Surgeons ; Sutures ; Urinary Retention

PURPOSE: The most common risk factor for fecal incontinence (FI) is obstetric injury. FI affects 1.4%–18% of adults. Most patients are unaware when they are young, when symptoms appear suddenly and worsen with aging. Autologous fat graft is widely used in cosmetic surgical field and may substitute for injectable bulky agents in treating FI. Authors have done fat graft for past several years. This article reports the effectiveness of the fat graft in treating FI and discusses satisfaction with the procedure. METHODS: Fat was harvested from both lateral thighs using 10-mL Luer-loc syringe. Pure fat was extracted from harvests and mixed with fat, oil, and tumescent through refinement. Fats were injected into upper border of posterior ano-rectal ring, submucosa of anal canal and intersphincteric space. Thirty-five patients with FI were treated with this method from July 2016 to February 2017 in Busan Hangun Hospital. They were 13 male (mean age, 60.8 years) and 22 female patients (mean age, 63.3 years). The Wexner score was checked before procedure. We evaluated outcome in outpatients by asking the patients. For 19 patients we checked the Wexner score after procedure. RESULTS: Symptom improved in 29 (82.9%), and not improved in 6 (17.1%). In 2 of 6 patients, they felt better than before procedure, although not satisfied. No improvement in 4. Mean Wexner score was 9.7 before procedure. There were no serious complications such as inflammation or fat embolism. CONCLUSION: Autologous fat graft can be an effective alternative treatment for FI. It is safe and easy to perform, and cost effective.
Adult ; Aging ; Anal Canal ; Busan ; Embolism, Fat ; Fats ; Fecal Incontinence ; Female ; Humans ; Inflammation ; Male ; Methods ; Outpatients ; Risk Factors ; Syringes ; Thigh ; Transplants