Alcohol abuse is related to a wide variety of medical complications including liver diseases, pancreatitis, cardiovascular diseases, immunological abnormalities, malignant neoplasms, endocrine disturbances, and kidney problems. The liver is the organ most severely affected by alcoholism. Alcoholic liver disease (ALD) remains a major cause of morbidity and mortality in Korea. The mainstay of therapy for alcohol-related medical problems is cessation of drinking. This article summarizes alcohol-related medical complications and treatment with focus on alcoholic liver injury.
Alcoholics ; Alcoholism* ; Cardiovascular Diseases ; Drinking ; Humans ; Kidney ; Korea ; Liver ; Liver Diseases ; Liver Diseases, Alcoholic ; Mortality ; Pancreatitis

BACKGROUND/AIMS: This study introduces methods for estimating the cost of liver disease and presents useful and reliable sources of data. The available evidence on the costs associated with liver disease is also discussed. METHODS: Costing methodology can be used to identify, measure, and value relevant resources incurred during the care of patients with liver diseases. It adjusts for discounting, skewed distribution, and missing or censored cost data. The human capital approach for productivity cost assumes that deceased patients would have lived to a normal expected life expectancy, and have earned a salary in line with the current age profile of wages, in order to measure potential earnings lost due to premature death or job loss. EVIDENCE: The number of deaths due to liver cancer (C22) increased from 6,384 in 1983 to 11,405 in 2013, while deaths due to other liver diseases (K70-K76) increased from 12,563 in 1983 to 13,458 in 1995, and then declined to 6,665 in 2013. According to the Global Burden of Disease study conducted by the World Health Organization, liver cancer caused 325,815 disability-adjusted life years (DALYs), and cirrhosis of the liver caused 206,917 DALYs in 2012. The total cost of liver disease was estimated at 1,941 billion Korean won in 2001 and 5,689 billion Korean won in 2008. Much of this cost is attributable to productivity cost, and especially that of economically active men. CONCLUSIONS: The economic burden of liver disease is immense because of the associated high mortality and morbidity, especially among the economically active population. This indicates the need to prioritize the development of appropriate health interventions.
Cost of Illness ; Humans ; Liver Diseases/*economics/epidemiology/mortality ; Liver Neoplasms/*economics/epidemiology/mortality ; Republic of Korea/epidemiology

No abstract available.
Liver Diseases ; Liver ; Mortality ; Non-alcoholic Fatty Liver Disease ; Risk Factors

PURPOSE: Metabolic liver disease may progress to liver cirrhosis or fulminant hepatic failure. Liver transplantation has been indicated in children with metabolic liver disease as an established curative treatment modality. METHODS: Between October 1986 and December 1999, 139 pediatric liver transplantations were performed in 119 patients. Twenty nine liver transplantations were underwent in 24 patients (16 males/8 females, mean age +/-SD: 8.2+/-5.6 yr, ranging 3 months-17 yrs) for metabolic liver disease (20.2%). Of 24 patients, 3 cases (12.5%) with primary hyperoxaluria type 1 underwent combined liver/kidney transplantations. Multiple liver transplantations were performed in 3 patients (1 patient: 3 times, 2 patients: 2 times). Twenty five orthotopic liver transplants were performed in 22 patients (91.7%), while 3 cases of auxiliary heterotopic liver transplants were done in 2 patients (8.3%). The mean follow-up period was 48.2+/-37.2 months (ranging 6-133 months). RESULTS: Patient and graft survival in metabolic disease at 1 year were 91.5%, 89.1%, in non-metabolic disease, 74.1%, 71.2%, respectively. Twelve patients (50%) suffered at least one episode of acute rejection after transplantation. The one-year-patient survival of rejection group was 91.7%, non-rejection group, 91.7%. Mortality developed in 6 patients (25%) after transplantation. The causes of death were sepsis (n=3), hepatic failure (n=2) and chronic rejection (n=1). CONCLUSION: The result of liver transplantation in metabolic liver disease seems to be better than non-metabolic liver disease (p>0.05). No difference was found between rejection and non-rejection group in one-year-patient survival (91.7% vs. 91.7%).
Cause of Death ; Child ; Female ; Follow-Up Studies ; Graft Survival ; Humans ; Hyperoxaluria, Primary ; Liver Cirrhosis ; Liver Diseases* ; Liver Failure ; Liver Failure, Acute ; Liver Transplantation* ; Liver* ; Metabolic Diseases ; Mortality ; Sepsis

Adolescent ; Adult ; Aged ; Female ; Follow-Up Studies ; Humans ; Liver Diseases ; diagnosis ; mortality ; surgery ; Liver Failure ; mortality ; surgery ; Liver Transplantation ; mortality ; Male ; Middle Aged ; Prognosis ; Risk Factors ; Young Adult

No abstract available.
Humans ; Liver Cirrhosis/*diagnosis/*mortality ; Liver Diseases/*diagnosis/*mortality ; Prognosis ; Severity of Illness Index ; Survival Rate ; Time Factors

BACKGROUNDS/AIMS: We present our experience of laparoscopic liver resection for various liver diseases. METHODS: From April 2008 to August 2012 in Chungnam National University, 68 of 253 liver resections were performed laparoscopically. During the first year, laparoscopy-assisted liver resection was mainly performed and subsequently totally laparoscopic liver resection was the main operative type. Surgery type for treatment purposes was decided preoperatively. Clinical data were collected retrospectively and analyzed. RESULTS: Preoperatively, 43 patients (63.2%) were diagnosed with benign disease, 19 patients (27.9%) were malignant liver tumors and 6 patients (8.8%) were indeterminate liver tumor but favorable towards malignancy. Anatomical major liver resection was performed in 58 cases (85.3%) and 10 cases (14.7%) were non-anatomical resection. Left hemihepatectomy was performed in 38 cases (55.8%) followed by left lateral sectionectomy in 18 cases (26.5%), and segment IV and IVa segmentectomy, were each in 1 case. Mean operation time was 235.0 minutes (range, 60-470) and 14 patients (18.6%) had intraoperative transfusion. Mean postoperative hospital stay was 10.2 days (range, 4-32). Mean operation time of laparoscopy-assisted left lobectomy was 317 minutes and totally laparoscopic left lobectomy was 281 minutes, but there was no significant statistical difference between these two operation types. There were 11 episodes of postoperative complications in 8 patients. There was no mortality after laparoscopic liver resection. CONCLUSIONS: We concluded that laparoscopic liver resection is a feasible operation, but needs to be carefully conducted in malignant tumors.
Chungcheongnam-do ; Humans ; Laparoscopy ; Length of Stay ; Liver Diseases* ; Liver* ; Mastectomy, Segmental ; Mortality ; Postoperative Complications ; Retrospective Studies

Liver abscess is a rare disease but shows a high mortality rate. The standard treatment is complete drainage of the abscess through surgery or insertion of a percutaneous catheter and proper antibiotic treatment. However, successful percutaneous drainage in a multiseptated abscess has several drawbacks, such as the necessity for inserting more than one catheter for proper drainage, a necessity for repetitive cathterization and moreover, the ultimate failure of effective drainage causing surgery to become inevitable. The authors used 80,000 IU urokinase three times per day over 5 days to lyse the fibrous septum in a 9-year-old child with multiseptated liver abscess. Catheter drainage with urokinase under radiologic intervention yielded successful a outcome in the treatment of a multiseptated liver abscess.
Abscess ; Catheters ; Child ; Drainage* ; Humans ; Liver Abscess* ; Liver* ; Mortality ; Rare Diseases ; Urokinase-Type Plasminogen Activator*

Budd-Chiari Syndrome is a rare disorder due to obstruction of hepatic venous outflow and generally follows a rapid fatal course. Hepatic vein thrombosis is a common complication with a high mortality rate and surgery for this condition is associated with a high perioperative mortality. Those who survive the acute phase almost invariably go on to develop cirrhosis of the liver and die within a few years from hepaic failure, bleeding esophageal varices or other complications of chronic liver disease. We have experienced the anesthetic management of three parients with Budd-Chiari syndrome who were treated with finger fracture and mesoatrial shunt. It is important that the anesthesiologist realizes that certain pathophysiological changes occur during the several surgical approaches to relieve the effect of hepatic vein obstruction, and perioper-ative hepatic dysfunction.
Budd-Chiari Syndrome* ; Esophageal and Gastric Varices ; Fibrosis ; Fingers ; Hemorrhage ; Hepatic Veins ; Humans ; Liver ; Liver Diseases ; Mortality

PURPOSE: The purpose of this study was to examine the clinical courses and long-term outcomes of children with Allagille syndrome in Korea, and to evaluate the prognostic potentials of identified variables. METHODS: We reviewed the clinical manifestations and outcomes of 30 children with Alagille syndrome, investigated from 1984 to 2006 until the end of this study (defined as death or last visit; mean follow-up : 5 years). RESULTS: Cholestasis occurred in 100 percent, cardiovascular abnormalities in 83.3 percent, butterfly vertebrae in 30.0 percent, posterior embryotoxon in 43.3 percent, and a characteristic facial appearance in 100 percent. At study conclusion, of these 30 patients, eight had died (26.7 percent); six related to Alagille syndrome. Five patients died of a liver disease complication. Liver transplantation was carried out in five of the 30 patients (16.7 percent) and one of these died due to hyperacute rejection. At age two, cholestasis improved in 17 of the 30 patients. Those who had severe cholestasis at 2 years of age tended to have a complication, such as liver cirrhosis or liver transplantation, or to have died. CONCLUSION: Hepatic complications account for the most mortalities in patients with Alagille syndrome. Careful and complete assessments should be made in children who have cholestasis at 2 years of age. Further investigations of more cases are required.
Alagille Syndrome* ; Butterflies ; Cardiovascular Abnormalities ; Child ; Cholestasis ; Follow-Up Studies ; Humans ; Korea* ; Liver Cirrhosis ; Liver Diseases ; Liver Transplantation ; Mortality ; Spine