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담석증 환자에서 복강경 담낭 절제 후 식도 기능 및 위 식도 역류의 변화

Other Titles
 Changes in the gastroesophageal Reflux and esophageal Function after Laparoscopic Cholecystectomies in Gall - Stone Patients 
 김경식  ;  김충배  ;  김병로  ;  최진섭  ;  이우정 
 Journal of the Korean Surgical Society (대한외과학회지), Vol.54(1) : 91-100, 1998 
Journal Title
 Journal of the Korean Surgical Society (대한외과학회지) 
Issue Date
It has been reported that dyspeptic symptoms in a minority of the patients who undergo cholecystectomy are persistent. Cholecystectomy may have a direct effect on the developmet of dyspeptic symptoms, predisposing the patient to increased duodenogastric reflux. Excessive reflux of noxious duodenal content into the stomach has been associated with chronic gastritis, gastric ulceration, and esophagitis. We examined 9 patients with gallstone disease who underwent laparoscopic cholecystectomy to determine the changes in the gastroesophageal reflux and the esophageal function. All the patients underwent looth standard esophageal manomery to study esophageal function and 24-hr esophageal pH monitroing to ascertain the gastroesophageal reflux the prior to at the time of, and 3 months after the laparoscopic cholecystectomy. The mean lower esophageal sphincter (LES) length, the abdominal esophageal sphincter length, and the resting pressure of LES were incerased from 3.1cm, 2.3cm 19.9mmHg to 3.2cm, 2.6cm, 22.9mmHg, with no statistical significance. The mean sphincter function index increased from 1484 to 1888 after the operation with no statistical significance. The mean ampulitude of contraction in the upper, the middle, and the lower portions of the esophageal body, but again increased from 44.4mmHg, 59.8mmHg, and 87.5mmHg to 56.7mmHg, 84.44mmHg, and 117.8mmHg, respectively, after the operation. The mean DeMeester acid reflux score decreased from 13.5 to 7.0 after the operation(p=0.343). In this study, the laparoscopic cholecystectomy did not affect the lower esophageal sphincter function. However there was an increase in the amplitude and the duration of contractions in the esophageal body. Therefore, the heartburn that persists after a cholecystectomy may be an esophageal origin. We suggest that al patients with biliary symptoms, but without documented acute cholecystitis should undergo full upper gastrointestinal investigations with esophagogastroduodenoscopy and pH monitoring (especially dual channel gastric and esophageal pH moniotring) to differentiate the esophageal pathology from other origins.
Appears in Collections:
1. College of Medicine (의과대학) > Dept. of Surgery (외과학교실) > 1. Journal Papers
Yonsei Authors
Kim, Kyung Sik(김경식) ORCID logo https://orcid.org/0000-0001-9498-284X
Lee, Woo Jung(이우정) ORCID logo https://orcid.org/0000-0001-9273-261X
Choi, Jin Sub(최진섭)
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