위암 환자의 위절제술 후 발생한 악성 폐쇄성 황달
Malignant Obstructive Jaundice Following Gastrectomy for Gastric Carcinoma
주재균, 김형록, 김동의, 김영진, 김신곤,
소속 상세정보
주재균 ( Ju Jae-Kyun )
전남대학교 의과대학 외과학교실
김형록 ( kim Hyeong-Rok )
전남대학교 의과대학 외과학교실
김동의 ( Kim Dong-Yi )
전남대학교 의과대학 외과학교실
김영진 ( Kim Young-Jin )
전남대학교 의과대학 외과학교실
김신곤 ( Kim Shin-Kon )
전남대학교 의과대학 외과학교실
KMID : 0371320010600050520
Abstract
Purpose: Although obstructive jaundice is a rare presentation, it is an omnious prognostic sign in patients with gastrectomy for gastric carcinoma. The major cause of bile duct obstruction has been identified as lymphadenopathy in the hepatoduodenal ligament that has metastasized from predominantly advanced gastric carcinomas.
Methods: Extrahepatic biliary obstruction caused by metastatic gastric carcinoma was retrospectively studied in order to determine demographics, pathological characteristics, time interval from previous gastrectomy, site of recurrence, and the prognosis of the disease.
Results: In this study, 983 patients with gastric adenocarcinoma underwent gastrectomy, and obstructive jaundice was revealed in 22 patients (2.2%). The mean age of the patients was 56 years, and the male to female sex ratio was 1.7：1. Antrally located, poorly differentiated, and advanced stage (above III) gastric carcinoma were commonly associated with obstructive jaundice. The most common site of the obstruction was the porta hepatis (54%). A percutaneous transhepatic biliary drainage (PTBD) procedure was accomplished in 19 patients and the jaundice was decreased, however the survival was not improved. The mean duration from jaundice to death was 2.8 months.
Conclusion: These results show that the cause of bile duct obstruction in advanced gastric carcinoma was predominantly metastatic lymphadenopathy in the hepatoduodenal ligament. In order to improve the quality of life in obstructive jaundiced patients, further evaluation and continued follow-up and examination may be necessary.
키워드
위절제술;폐쇄성 황달
Gastrectomy;Obstructive jaundice
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