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| 1 | Quality of survival in patients treated for malignant biliary obstruction caused by unresectable pancreatic head cancer: surgical versus non-surgical palliation显示文摘BACKGROUND:Appropriate palliation for unresectable pancreatic head cancer is most important.This study was undertaken to compare the survival of patients with biliary obstruction caused by unresectable pancreatic head cancer after surgical and non-surgical palliation. METHODS:We retrospectively reviewed 69 patients who underwent palliative treatment for unresectable pancreatic head cancer.Fifty-two patients with locally advanced disease (local vascular invasion)and 17 with distant metastatic disease were included.The patients were divided into two groups,surgical and non-surgical palliation. RESULTS:Thirty-eight patients underwent biliary bypass surgery and 31 had percutaneous transhepatic biliary drainage(PTBD).There was no significant difference in the early complications,successful biliary drainage, recurrent jaundice,and 30-day mortality between surgical palliation and PTBD.However,in 52 patients whose tumor was unresectable secondary to local vascular invasion,the rate of recurrent jaundice after successful surgical biliary palliation was lower than that in patients who had non- surgical palliation(P<0.05).The patients who underwent surgical palliation had a longer hospital-free survival rate(P<0.001),although they had a longer postoperative hospital stay(P=0.004)during the first admission period.CONCLUSIONS:In patients with preoperative evaluations showing potentially resectable tumors and/or no metastatic lesions,surgical exploration should be performed.Thus,in patients who have unresectable cancer or limited metastatic disease on exploration,surgical palliation should be performed for longer survival and better quality of survival. | Hyung Ook Kim Sang Il Hwang Hungdai Kim Jun Ho Shin | 2008 | Hepatobiliary & Pancreatic Diseases International2008，7，6： | 8 |
| 2 | Outcome of laparoscopic cholecystectomy is not influenced by chronological age in the elderly显示文摘AIM:To evaluate the outcome of laparoscopic cholecystectomy(LC)in patients aged 80 years and older. METHODS:A total of 353 patients aged 65 to 79 years(group 1)and 35 patients aged 80 years and older(group 2)underwent LC.Patients were further classified into two other groups:those with uncomplicated gallbladder disease(group A)or those with complicated gallbladder disease(group B). RESULTS:There were no significant differences between the age groups(groups 1 and 2)with respect to clinical characteristics such as age,gender,comorbid disease,or disease presentation.Mean operative time,conversion rate,and the incidence of major postoperative complications were similar in groups 1 and 2.However,the percentage of high-risk patients was significantly higher in group 2 than in group 1 (20.0%vs 5.7%,P<0.01).Group A comprised 322 patients with a mean age of 71.0±5.3 years,and group B comprised 51 patients with a mean age of 69.9±4.8 years.In group B,mean operative time (78.4±49.3 min vs 58.3±35.8 min,P<0.01),mean postoperative hospital stay(7.9±6.5 d vs 5.0±3.7 d, P<0.01),and the incidence of major postoperative complications(9.8%vs 3.1%,P<0.05)were significantly greater than in group A.The conversion rate tended to be higher in group B,but this difference was not significant. CONCLUSION:Perioperative outcomes in elderly patients who underwent LC seem to be influenced by the severity of gallbladder disease,and not by chronologic age.In octogenarians,LC should be performed at an earlier,uncomplicated stage of the disease whenever possible to improve perioperative outcomes. | Hyung Ook Kim Jung Won Yun Jun Ho Shin Sang Il Hwang Yong Kyun Cho Byung Ho Son Chang Hak Yoo Yong Lai Park Hungdai Kim | 2009 | World Journal of Gastroenterology2009，15，6： | 5 |
| 3 | Surgical palliation of unresectable pancreatic head cancer in elderly patients显示文摘AIM: To determine if surgical biliary bypass would provide improved quality of residual life and safe palliation in elderly patients with unresectable pancreatic head cancer. METHODS: Nineteen patients, 65 years of age or older, were managed with surgical biliary bypass (Group A). These patients were compared with 19 patients under 65 years of age who were managed with surgical biliary bypass (Group B). In addition, the results for group A were compared with those obtained from 17 patients, 65 years of age or older (Group C), who received percutaneous transhepatic biliary drainage to evaluate the quality of residual life. RESULTS: Five patients (26.0%) in Group A had complications, including one intraabdominal abscess, one pulmonary atelectasis, and three wound infections. One death (5.3%) occurred on postoperative day 3. With respect to morbidity, mortality, and postoperative hospitalization, no statistically significant difference was noted between Groups A and B. The number of readmissions and the rate of recurrent jaundice were lower in Group A than in Group C, to a statistically significant degree (P = 0.019, P = 0.029, respectively). The median hospital-free survival period and themedian overall survival were also signifi cantly longer in Group A (P = 0.001 and P < 0.001, respectively). CONCLUSION: Surgical palliation does not increase the morbidity or mortality rates, but it does increase the survival rate and improve the quality of life in elderly patients with unresectable pancreatic head cancer. | Sang Il Hwang Hyung Ook Kim Byung Ho Son Chang Hak Yoo Hungdai Kim Jun Ho Shin | 2009 | World Journal of Gastroenterology2009，15，8： | 4 |
| 4 | Short-term outcomes of laparoscopic-assisted distal gastrectomy for gastric cancer during a surgeon’s learning curve period显示文摘 | Chang Hak Yoo Hyung Ook Kim Sang Il Hwang Byung Ho Son Jun Ho Shin Hungdai Kim | 2009 | Surgical Endoscopy2009，，10： | 1 |
| 5 | Surgical outcomes of Korean ulcerative colitis patients with and without colitis-associated cancer显示文摘AIM: To determine the clinicopathologic characteristics of surgically treated ulcerative colitis(UC) patients, and to compare the characteristics of UC patients with colitis-associated cancer(CAC) to those without CAC. METHODS: Clinical data on UC patients who underwent abdominal surgery from 1980 to 2013 were collected from 11 medical institutions. Data were analyzed to compare the clinical features of patients with CAC and those of patients without CAC.RESULTS: Among 415 UC patients, 383(92.2%) underwent total proctocolectomy, and of these, 342(89%) were subjected to ileal pouch-anal anastomosis. CAC was found in 47 patients(11.3%). Adenocarcinoma was found in 45 patients, and the others had either neuroendocrine carcinoma or lymphoma. Comparing the UC patients with and without CAC, the UC patients with CAC were characteristically older at the time of diagnosis, had longer disease duration, underwent frequent laparoscopic surgery, and were infrequently given preoperative steroid therapy(P < 0.001-0.035). During the 37 mo mean follow-up period, the 3-yearoverall survival rate was 82.2%.CONCLUSION: Most Korean UC patients experience early disease exacerbation or complications. Approximately 10% of UC patients had CAC, and UC patients with CAC had a later diagnosis, a longer disease duration, and less steroid treatment than UC patients without CAC. | Yong Sik Yoon Yong Beom Cho Kyu Joo Park Seung Hyuk Baik Sang Nam Yoon Seung-Bum Ryoo Kil Yeon Lee Hungdai Kim Ryung-Ah Lee Chang Sik Yu | 2015 | World Journal of Gastroenterology2015，21，12： | 0 |
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