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KMID : 0371319960510010001
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Journal of the Korean Surgical Society
1996 Volume.51 No. 1 p.1 ~ p.10
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Kobayashi Procedure for Esophageal Varix Bleeding
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김재민
전규영/신동일/박찬대/권오정/권성준/정파종/이광수/원치규
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Abstract
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Eleven patients were treated for esophageal varices using the Kobayashi procedure be tween 1988 and 1994. This surgical procedure include distal esophageal and upper gastric devascularization, esophageal transection in all cases. Splenectomy was
performed in ten cases and distal splenorenal shunt was performed in one case. In accordance with Child's classification, 36% were considered as class A, 36% as class B, and 27% as class C. The etiology of the associated cirrhosis included
hepatitis
B(92%) and alcohol abuse(0.9%). One patient had extrahepatic portal hypertension from unknown causes. The average operative time was 5 hours. The average blood transfusion during operation was 2 units of packed cell. The operative mortality rate
was
9.1%. The cause of death was postoperative bleeding due to DIC. Encephalopathy did not develop in any patients. One case was performed using the Kobayashi procedure which contained the distal splenorenal shunt without splenectomy. This case
showed
a
good outcome although the follow up period was short. When applied in the appropriate clinical setting, Kobayashi procedure affords excellent control of variceal bleeding and maintenance of liver function t a stable level.
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KEYWORD
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