No abstract available.
Afferent Loop Syndrome*

No abstract available.
Cholecystectomy, Laparoscopic* ; Hemodynamics* ; Prospective Studies*

No abstract available.
Gastrectomy* ; Stomach Neoplasms*

Laparascapic Cholecystectomy is a recentely rapidly emerged, minimally invasive procedure whereby the gallbladder is removed using laparoscopic techniques. The procedure offers the patient reduced hospital stay, faster to work, less pain, less complication, less expensiveness, and improved cosmetic results over the traditional open cholecystectomy. (continue...)
Cholecystectomy* ; Cholelithiasis* ; Gallbladder ; Humans ; Laparoscopy* ; Length of Stay

This study was performed to evlauate the usefulness of red ginseng extract as an adjuvant therapeutic agent to improve immune function in immune compromizing gastrointestinal carcinoma patients. We treated 48 patients with two regimens after we undertook the curative resection for gastrointestinal carcinoma: 1) only chemotherapy and immunotherapy (control group), 2) chemotherapy and immunotherapy with 4500-5400mg red ginseng for 6 months (study group). For investigating the immunologic alternations alongside the numerical changes in peripheral blood lymphocyte and their subsets in the gastrointestinal carcinoma patients, lymphocyte surface markers were determined by monoclonal antibodies on the preoperative 1st day, and postoperative 5th day, 1 month, 3 month and 6 month in 28 controls and 20 red ginseng groups in gastrointestinal carcinoma patients which were recruited at Korea University Hospital from March, 1995 to December, 1995. The mean value for body weight was increased in the ginseng group than in the control group. There were no significant differences of serum hematocrit, hemoglobin, total protein and albumin in both groups. The total lymphocyte count was much more increased in the ginseng group than in the control group. The number of T cell, B cell, CD8, CD4, NK cell and activated T cell were increased in ginseng group more than in control group. The T cell was significantly increased on postoperative 5th day, 3 month and 6 month, and B cell on postoperative 6 month in ginseng group than in control group. The CD8 was significantly increased on postoperative 3 month and 6 month, CD4 on postoperative 5th day, and NK cell and activated T cell also on postoperative 6 month in ginseng group than in control group. In conclusion, red ginseng may be useful as a longterm adjuvant therapeutic agent for improving the immune function and anticarcinogenic effect after curative operation for immune compromizing gastrointestinal carcinoma patients.
Antibodies, Monoclonal ; Anticarcinogenic Agents ; Body Weight ; Drug Therapy ; Hematocrit ; Humans ; Immunotherapy ; Killer Cells, Natural ; Korea ; Lymphocyte Count ; Lymphocytes ; Panax*

BACKGROUND: Studies of immune response for cancer have demonstrated that the antitumor immune response plays a role in competing against the growth of cancer cells and is frequently altered in advanced cancer. METHODS: We evaluated the changes of peripheral blood lymphocytes and their subsets during preoperative and postoperative periods according to the time sequence of the postoperative condition in gastrointestinal carcinoma patients. Lymphocyte surface markers were determined in 39 stomach cancer patients and 33 colon cancer patients by using the indirect immunofluorescence technique with monoclonal antibodies. The patient's body weights, hemoglobin, hematocrits, total protein, and albumin were also measured preoperatively at and 1, 3, 6, 12, 18, and 24 months postoperatively. RESULTS: There were significant differences of clinico-laboratory findings between the preoperative and the postoperative periods except for hemoglobin, total protein, and albumin in postoperative course. The total leukocyte count significantly decreased from the postoperative 6th month. The lymphocyte count significantly increased from the postoperative 3rd month. The granulocytes decreased significantly in the postoperative 6th month. The T cells and B cells decreased in the postoperative 3rd month and 1st month, respectively. CD8 increased in the postoperative 3rd month and NK cells also increased in the postoperative 3rd, 6th and 24th months. Other peripheral lymphocytes and their subsets showed no significant differences. The changes in the lymphocyte subsets according to stage were not statistically significant (p<0.005). CONCLUSIONS: The postoperative changes in lymphocytes, granulocytes, and NK cells were significantly different compared with preoperative levels, but these results did not correlate with postoperative survival and recurrence rate because of the short postoperative follow-up periods.
Antibodies, Monoclonal ; B-Lymphocytes ; Body Weight ; Colonic Neoplasms ; Fluorescent Antibody Technique, Indirect ; Follow-Up Studies ; Granulocytes ; Hematocrit ; Humans ; Killer Cells, Natural ; Leukocyte Count ; Lymphocyte Count ; Lymphocyte Subsets ; Lymphocytes* ; Postoperative Period ; Recurrence ; Stomach Neoplasms ; T-Lymphocytes

BACKGROUND: In Despite of progress in diagnostic technique, early diagnosis of pancreatic ductal adenocarcinoma is still difficult. It has low resectability and poor prognosis. Cancer staging are to aid in planning treatment and in predicting prognosis. The Union Internationale Contre le Cancer (UICC) classification and Japanese Pancreatic Society (JPS) classification are used for the staging system of pancreatic ductal adenocarcinoma. Though these staging systems are still evolving, there are some discrepancy in the prognosis between two staging systems. METHOD: To investigate these discrepancies we researched the survival rate of pancreatic ductal adenocarcinoma according to each staging system. Between 1983 to 1995, a total 52 patients underwent resective surgery for pancreatic adenocarcinoma were studied. RESULTS: In stage classification, the rate of stage I and II in UICC classification (46.2%) was more higher than in JPS classification (23.1%)(p<0.05). The 3 year survival rate of stage I was significantly higher than other stages in UICC classification. But in the survival curves, UICC classification did not reflect difference between stage II and III. In JPS classification, survival rates and curves differed according to the four stages. On T category (tumor invasion or size), the survival rate decreased as tumor invasion was increased in both classifications. In UICC classification, the 3-year survival rate was significantly higher in the patients of stage N0 than in the patients of N1 (p<0.05). CONCLUSION: The UICC system is simple, but it does not fully predict prognosis. The JPS system is well in predict of prognosis, but it has a disadvantage of complexities. Continuing efforts are necessary to establish a more practical, proper, and universal staging system for pancreatic adenocarcinoma.
Adenocarcinoma ; Asian Continental Ancestry Group ; Classification ; Early Diagnosis ; Humans ; Neoplasm Staging ; Pancreatic Ducts ; Pancreatic Neoplasms* ; Prognosis ; Survival Rate*

PURPOSE: To evaluate factors that predict prognosis of colon perforation, we review the hospital records of 37 patients who underwent emergency operation for colon perforation. METHODS: Information of clinical findings, Acute Physiology and Chronic Health Evaluation (APACHE II score), perforation sites and causes, operation methods, and postoperative complications were obtained. RESULTS: The causes of perforation were traumatic 11 (29.7%), iatrogenic 10 (27.0%), diverticular 6 (16.2%), cancerous process 6 (16.2%), strangulated hernia 2 (5.4%), ischemic colitis 1 (2.7%) and stercoral 1 (2.7%). The longer duration from colon perforation to operation, the more severe intra-abdominal fecal contamination was seen. The complication rate was increased as the intra-abdominal fecal contamination increased or APACHE II score increased (p<0.05). But there were no correlation between the complication rate and perforation sites and causes. In according to operative managements, one-stage operation (simple closure or resection with anastomosis) group had more lower complication rate than two-stage operation (formation of colostomy) group, unexpectedly (31.3% vs. 52.4%, p>0.05). Also former group had lower complication rate compared to latter group in left colon (40% vs 50%). CONCLUSIONS: The factors that predict of mortality and morbidity are not perforation site, causes, and operation method, but preoperative physiologic status (APACHE II score) and intra-abdominal fecal contamination. So preoperative proper and vigorous treatment for improvement of physiologic status and shortening of interval to operation are important for better results. And primary closure and resection with anastomosis is useful for colon perforation in selected circumstance regardless of its site and cause.
APACHE ; Colitis, Ischemic ; Colon* ; Colostomy ; Emergencies ; Hernia ; Hospital Records ; Humans ; Mortality ; Postoperative Complications ; Prognosis

A 69-year-old woman developed right upper quadrant pain and jaundice 4 years after laparoscopic cholecystectomy for cystic duct obstruction by stone. Two stones with a metallic clip nidus in common bile duct were diagnosed with abdominal sonography and endoscopic retrograde cholangiography. Endoscopic retrieval of the stones and a metallic clip was successfully performed. Nowadays, laparoscopic surgery has become a very common procedure, and metallic clips are used more frequently. Therefore, in order to avoid CBD stone and other complications caused by metallic clips, careful application and strict follow-up shoued be stressed during laparoscopic biliary surgery.
Aged ; Cholangiography ; Cholecystectomy, Laparoscopic* ; Choledocholithiasis* ; Common Bile Duct ; Cystic Duct ; Female ; Follow-Up Studies ; Humans ; Jaundice ; Laparoscopy

Until now, surgical treatment of bile duct carcinoma has been unsatisfactory. There have been few reports dealing with the clinical significance of epidermal growth factor receptor(EGFR) and c-erbB-2 in bile duct cancer. To evaluate epidermal growth factor receptor(EGFR) and c-erbB-2 protein as a marker for prognosis, we analyzed the data and outcome of 32 cases of extrahepatic bile duct carcinoma immunohistologically, as well as clinicopathologically. The expressions of EGFR and c-erbB-2 showed in 71.9%(23/32) and 34.4%(11/32), respectively. The expression of EGFR was closely associated with the expression of c-erbB-2 (p<0.05). The expression rate of EGFR was significantly higher in well-differentiated cancer than in poorly-differentiated cancer (p<0.05), but was not related to stage, or lymph node metastasis. The expression of c-erbB-2 was not related to stage, lymph node metastasis, and differentiation. The expressions of EGFR and c-erbB-2 did not correlate with survival. In conclusion, the expression of EGFR or c-erbB-2 may be used as a tumor marker, but not as a prognostic factor in extrahepatic bile duct cancer.
Bile Duct Neoplasms ; Bile Ducts ; Bile Ducts, Extrahepatic* ; Epidermal Growth Factor ; Lymph Nodes ; Neoplasm Metastasis ; Prognosis ; Receptor, erbB-2