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KMID : 0371319610030010013
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Journal of the Korean Surgical Society
1961 Volume.3 No. 1 p.13 ~ p.42
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Surgery of the Liver and Biliary Tract
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張起呂/Chang, Kee-Rye
閔泳玉/白泰潤/金珍植/李衡珍/鄭雨英/李仁洙/--/--/--/--/--/--
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Abstract
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The following is the summary of the work regarding the surgery on the liver and the bile duct carrid out by the-cominon-bile _duct wall, -of liver function tests and and bile´ ducts in ` the porta ´ hepatis, should be doubip of surgioa ,.:autcome.-=These studies were completed for ligated´-individually:and?-sectioned. ´Theasurg&ri must ,be eacli °of-four -different surgical reconstruction procedures certain that all tributaries of the hepatic vein are p. properly used .The best result was obtained on the viewpoint of ligated and that no avascular liver tissue is left in situ. function with duct-to-duct anastomosis and the next was 14) There should be no-interlocking mattress --suture.,or in order of result, duct-tojejunum anastomosis with covering of the cut surface with the -falciform: ligament proximal Roux en-Y, duct-to-jejunum anastomosis with or the omentum after hepatic 3obectoiriy: It -is. Fbest- to proximal Braun´s anastomosis and duct-to -duodenum leave the cut surface bare. This was proved in animal anastomosis. On the view-point of operative risk, the best experiments.
result was obtained with duck -to-duodenum anastomosis 15) During surgery -in-the abdomen, liverr biopsy and and the next was in order of result, duct-to-jejunum measurement of portal pressure ?were routinely made. In with proximal Braun´s enteroenteroanastomosis, duct-to- a patients in whom there was presumed to be no cause jejunum with proximal Roux en-Y arm and duct-to-duct. for increased portal pressure, the normal portal -pressure
11) Experimentally induced infection with clonorchis was 154 E26 mm/saline. In cases of liver ?_disfunction due sinensis was studied in rabbits. The adult worms -were to nutritional -deficiency caused by pyloric stenosis or found in the biliary tracts in the liver 4 weeks after the shock due to acute peritonitis, the portal. pressure administration of metacercaria, at which time the generally decreased. In other liver disfunction cases,. the proliferation of the biliary tracts in Glisson´s sheath -as pressure was generally higher :it was highest in. cases well, as pronounced fibrosis had already occurred. of liver cirrhosis with liver cancer, the increased, pressure
.At: the,5th week, there appeared pseudolobul in the occurred in liver cirrhosis,. Banti´s syndrome, ,obstructive
liver and at the 6 to 8 th week, regenerative change in jaundice and hepatitis .in that:. order.
parenchymal cells of the liver was seen. Granular 16) Dogs with experimentally produced Eck.fistula were
proliferation of the biliary tract system was seen at the studied. The group in which implantation -of the, -gastric
13th week and finally at.around the 15th to 18th week, artery was made into the ,liver.had better liver functional
there -was a -return to normalization by -regeneration of ability than the group- in which. only the Eck fistula
liver -parenchyma- were made.
12) Cancer of the liver occupies 4, 2 percent of total 17) For treating portal hypertention, improvement ;can
malignant tumor series in Korea. hardly be expected from conservative medical treatment
13) The operative procedure of right hepatic lobectomy but surgical intervention, though temporary, may
and -left lobectomy are not dangerous; vascular components improve or ease the symptom.
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KEYWORD
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