절제 불가능한 팽대부 주위암에서 위공장 문합술 시행시 병행한 십이지장 분배술식의 임상적 의의
Gastrojejunostomy with Duodenal Partition for Unresectable Periampullary Cancer
신준호, 박재준, 한원곤,
소속 상세정보
신준호 ( Shin Jun-Ho )
성균관대학교 의과대학 강북삼성병원 외과학교실
박재준 ( Park Jae-Jun )
성균관대학교 의과대학 강북삼성병원 일반외과
한원곤 ( Han Won-Kon )
성균관대학교 의과대학 강북삼성병원 일반외과
KMID : 0371320010610030300
Abstract
Purpose
The most appropriate palliative treatment to relieve symptoms caused by extrahepatic biliary obstruction appears to be a surgically constructed double bypass. However, gastrojenunostomy may be a disease rather than an operation because the
ingested
food
would take the duodenal route and reenter the stomach through the gastrojejunostomy. Therefore, there has been a renewed interest in the role of the duodenal partition for preventing this circulus vomitig.
Methods
A total of 97 patients were treated with palliative loop gastrojejunostomy due to unresectable periampullary cancer at Kangbuk Samsung Hospital between March 1998 and December 2000. Of the 56 patients of this group who underwent prophylactic
gastrojejunostomy, 25 patients had both gastojejunostomy and duodenal partition (Group
I) and 31 gastrojejunostomy alone (Group II).
Results
The postoperative in-hospital mortality rate was 0 percent and the morbidity rate was 5.4 percent. However, the morbidity rate associated with duodenal partition was 0 percent. Circulus vomiting was absent in patients who had a duodenal
partition,
although statistical analysis did not show this to be significant. The reason for the statistical insignificance of the result may be the relatively small sample size.
Conclusion
Due to the ease and safety of the technique, the duodenal partition added to the loop gastrojejunostomy decreased circulus vomiting without prolonging the operative time or increasing the compication rates. This finding suggests that the duodenal
partition should be liberally applied in prophylactic gastric bypass procedures.
키워드
팽대부 주위암; 순환구토; 십이지장 분배술식; Periampullary cancer; Circulus vomiting; Duodenal partition;
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