Kosin Medical Journal

Review article

Basic knowledge of endoscopic retrograde cholangiopancreatography: Jung Wook Lee; Kosin Med J. 2023;38(4):241-251. Published online December 26, 2023; DOI: https://doi.org/10.7180/kmj.23.151

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Abstract PDF PubReader ePub: Endoscopic retrograde cholangiopancreatography (ERCP) was first performed in the late 1960s. Due to advancements in instruments, devices, and techniques, ERCP has played an important role in the management and diagnosis of pancreatobiliary disorders. However, ERCP is accompanied by the risk of various complications even if performed by an expert. The incidence of ERCP complications is approximately 4% to 10%, while the incidence of fatal complications, such as death, is less than 0.5%. To prevent adverse events, experts performing ERCP must recognize and address ERCP-related complications and understand the various techniques. In this review, we summarize the complications and techniques of ERCP.

Original article

Validation of the association of the cystic duct fibrosis score with surgical difficulty in laparoscopic cholecystectomy: Hyung Hwan Moon, Ji Hoon Jo, Young Il Choi, Dong Hoon Shin; Kosin Med J. 2022;37(1):61-67. Published online March 25, 2022; DOI: https://doi.org/10.7180/kmj.21.049

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Background
The level of surgical difficulty in laparoscopic cholecystectomy might be predictable based on preoperative imaging and intraoperative findings indicative of cholecystitis severity. Several scales for laparoscopic cholecystectomy have been developed, but most are complex, unverified, and not widely adopted. This study evaluated the association of the cystic duct fibrosis score (range, 0–3) with surgical difficulty in laparoscopic cholecystectomy.
Methods
Between July 2018 and November 2018, 163 laparoscopic cholecystectomy cases were retrospectively reviewed at a single center. Patients’ demographics, preoperative laboratory data, operation time, complications, hospital stay, and cholecystitis severity grade were investigated. We also evaluated the associations of the Tokyo Guidelines 2018 and the Parkland grading scale with the cystic fibrosis score.
Results
The cystic duct fibrosis score was associated with preoperative white blood cells (p<0.001), preoperative platelet count (p=0.046), preoperative total bilirubin (p<0.004), preoperative C-reactive protein (p<0.001), operation time (p<0.001), cystic duct ligation time (p=0.002), estimated blood loss (p<0.001), postoperative complication (p=0.004), open conversion (p<0.001), and common bile duct injury (p=0.010). The cystic duct fibrosis score was also correlated with the Tokyo Guidelines 2018 and the Parkland grading scale (p<0.001). The cystic duct ligation time predicted the cystic duct fibrosis score and the Parkland grading scale, but not the Tokyo Guidelines 2018.
Conclusion
As a simple indicator of cholecystitis severity, the cystic duct fibrosis score can predict the surgical difficulty and outcomes of laparoscopic cholecystectomy.

Citations

Citations to this article as recorded by

Correlation Between Preoperative Ultrasonography and Parkland Grading Scale in Patients Undergoing Laparoscopic Cholecystectomy
Burak Uçaner, Doğuş Durmuş, Mehmet Zeki Buldanlı, Oğuz Hançerlioğulları
Indian Journal of Surgery.2024; 86(1): 160. CrossRef

Case report

Endoscopic Removal of Remained Drawstring After Percutaneous Transhepatic Biliary Drainage: Tae Wook Yoon, Geun Yong Jung, Young Jun Park, Jun Young Choi, Jee Hwan Jung, Tae Gyoon Kim; Kosin Med J. 2016;31(2):173-178. Published online January 20, 2016; DOI: https://doi.org/10.7180/kmj.2016.31.2.173

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Abstract PDF PubReader ePub: Abstract
The percutaneous transhepatic biliary drainage (PTBD) is an effective intervention as a palliative therapy for relieving a jaundice and cholangitis. It may be used in place of Endoscopic retrograde cholangiopancreatography (ERCP) in the obstructive biliary disease. Recently, by developing invasive procedures, the incidence of the complications such as bleeding and perforation has been increasing in the diagnosis and treatment of hepatobiliary disease. We report here on a case of remained drawstring after PTBD in a 85-year-old man. The patient was conducted PTBD for relieving a jaundice and cholangitis. And then the patient had complained of abdominal pain constantly. A few days later, we removed PTBD and attempted ERCP for removal of CBD stone. The ERCP showed remained drawstring around ampulla of vater and we removed it by IT knife. The drawstring was successfully removed.

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