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손종일,최인석,이상억,나유미,최원준,윤대성,민현식 대한내시경복강경외과학회 2010 Journal of Minimally Invasive Surgery Vol.13 No.2
Purpose: ERCP (Endoscopic retrograde cholangiopancreatigraphy)and ES (endoscopic sphicterotomy) have become the main treatments for common bile duct (CBD) stone. However, when ERCP with ES fails to remove CBD stone, an operation is needed for stone removal. The aim of this study was to investigate the outcomes of laparoscopic CBD exploration (LCBDE) for the management of difficult choledocholothoasis. Methods: This study was a retrospective analysis of 106LCBDE cases that were performed from March 2001 to December, 2009. Results: Of the 106 patients who underwent laparoscopic procedures, 74 were combined with gallstone and 105underwent the choledochotomy approach. The mean operation time and mean hospital stay were 146.9±74.5minutes and 11.0±6.4 days, respectively. The open conversion and stone clearance rates were 3.8% (4 cases) and 96%(102/106 cases). There were 10 complications with 3 cases of bile leakage, 2 cases of pulmonary complications, 4 cases of remnant stone and 1 case of subhepatic seroma. Conclusion: The LCBDE is a safe and feasible procedure. If ERCP is difficult or stone retrieval is incomplete, then LCBDE could be an alternative treatment for difficult CBD stone.
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Are Hemorrhoids Associated with False-Positive Fecal Immunochemical Test Results?
김남희,정윤숙,박정호,박동일,손종일,최규용 연세대학교의과대학 2017 Yonsei medical journal Vol.58 No.1
Purpose: False-positive (FP) results of fecal immunochemical tests (FITs) conducted in colorectal cancer (CRC) screening couldlead to performing unnecessary colonoscopies. Hemorrhoids are a possible cause of FP FIT results; however, studies on this topicare extremely rare. We investigated whether hemorrhoids are associated with FP FIT results. Materials and Methods: A retrospective study was conducted at a university hospital in Korea from June 2013 to May 2015. Of the34547 individuals who underwent FITs, 3946 aged ≥50 years who underwent colonoscopies were analyzed. Logistic regressionanalysis was performed to determine factors associated with FP FIT results. Results: Among 3946 participants, 704 (17.8%) showed positive FIT results and 1303 (33.0%) had hemorrhoids. Of the 704 participantswith positive FIT results, 165 had advanced colorectal neoplasia (ACRN) and 539 had no ACRN (FP results). Of the 1303 participantswith hemorrhoids, 291 showed FP results, of whom 81 showed FP results because of hemorrhoids only. Participants withhemorrhoids had a higher rate of FP results than those without hemorrhoids (291/1176, 24.7% vs. 248/2361, 10.5%; p<0.001). Additionally,the participants with hemorrhoids as the only abnormality had a higher rate of FP results than those experiencing nosuch abnormalities (81/531, 15.3% vs. 38/1173, 3.2%; p<0.001). In multivariate analysis, the presence of hemorrhoids was identifiedas an independent predictor of FP results (adjusted odds ratio, 2.76; 95% confidence interval, 2.24–3.40; p<0.001). Conclusion: Hemorrhoids are significantly associated with FP FIT results. Their presence seemed to be a non-negligible contributorof FP results in FIT-based CRC screening programs.
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