Pediatric hernia
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:: Damsoyu hospital > Specialized Clinics > Gallbladder polyp ::

담낭용종

담소유외과는 진정한 외과전문병원 리더가 되기 위해 가장 먼저 도전하고 노력합니다.

국내최초 단일통로복강경 담낭절제술 1,000례 돌파

단일통로 복강경 담낭절제술

The existing laparoscopic cholecystectomy required many openings to conduct the surgery.
However, single port laparoscopic cholecystectomy is done by installing a special single port through the navel which allows many instruments to enter the port. Since the surgery is carried out with single port, the difficulty level is a lot higher than the original laparoscopic cholecystectomy, and requires skills and experience to proceed.

페이지 준비중입니다.

담소유외과의 단일통로 복강경담낭절제술은?

  1. 수술 시간이 짧습니다 - 염증이 없는 담낭결석의 수술은 20~30분 내로 수술이 끝납니다.

그래프-타병원과의 입원 기간 비교 / 담소유외과:1.3일, 상급병원:11.4일, 종합병원:13.1일, 병원:15.3일 / 출처:건강보험 심사평가원

전문마취의가 상주, 수면/전신 마취

  • Dam So Yu Hospital specializes in surgical operations not cosmetic surgeries
  • Dam So Yu Hospital specializes in surgical operation to a wide range of patients from newborn babies to adolescent under 18 years old. Inguinal hernia and other surgeries are conducted using laparoscopic surgical method.
  • When it comes to pediatric surgeries, it is important that surgeries are completely asepsis.
    This is why we use disposable sterilization wrap.
  • When conducting clean surgery, antibiotics are not injected. It’s because surgery is carried out completely asepsis. We do not inject antibiotics before carrying out surgery and no inflammation is caused.
  • 사진-마취과 전문의 송 은 과장 / 진료과목:마취과 / 학력:부산대학교 의과대학 졸업 / 경력:서울대병원 마취통증의학과 전공의, 서울대병원 마취통증의학과 전문의, 서울아산병원 마취통증의학과 전임의 / 학회활동:대한소아마취학회 정회원, 대한마취과학회 정회원, 대한통증학회 정회원, 대한통증학회 TPI과정 이수
  • 사진-마취과 전문의 장연희 과장 / 진료과목:마취과 / 학력:연세대학교 의과대학 졸업 / 경력:세브란스병원 마취통증의학과 전공의, 세브란스병원 마취통증의학과 전문의 / 학회활동: 대한마취과학회 정회원, 대한통증학회 정회원, 대한척추통증학회 정회원, 대한통증연구학회 정회원, 대한통증학회 TPI과정 이수

Dam So Yu Hospital specializes in surgical operation to wide range of patients from newborn babies to 70 years old senior patients. For patients’ health and safety, we have two experienced anesthesiologists, with wide clinical experiences.

복강경 수술기구 완비

laparoscopic system

Dam So Yu Hospital is equipped with 1288 HD system from Stryker’s.

사진-Stryker 1288 HD 2.9mm Camera

사진-좌:storz사의 5mm 복강경 기구, 우:stryker사의 5mm 복강경 기구

DRAGER FABIUS PLUS

사진-담소유외과 마취기구

We have two experienced anesthesiologists, with wide clinical experiences, taking charge of anesthesia. All three general anesthesia operating rooms are equipped with Dräger’s FABLUS PLUS. Some hospital put patients under sedation despite the fact that these hospitals are not equipped with or don’t possess general anesthesia equipment. Ideally, for safety reasons, hospitals need to be equipped with general anesthesia equipment even when putting patients under sedation. Our hospital has three aseptic operating rooms, equipped for general anesthesia.

담낭용종이란?

Excluding the gall stone, gallbladder polyp is a protruding wen on the wall of the inner side of the gall bladder. Simply, when there’s wen inside the gall bladder, it can be diagnosed as Gallbladder polyp. 3~7% of adults have gallbladder polyp and thanks to advancing ultrasonography, gradually more patients are being discovered to have gallbladder polyps. It is reported that women are more often diagnosed with gallbladder polyp than men.

그림-간,담관,췌장,소장,간,담낭,담낭관,총간담관,총수담관,췌장,십이지장

담낭용종의 종류

진성용종
Adenoma is originated from epithelial cell and hemangioma, lipoma, myoma outbreak from other tissue cells.
사진-진성용종
Types of pseudopolyp are cholesterol polyp, inflammatory polyp, proliferative polyp.
사진-가성용종

담낭용종의 원인

The cause of cholesterol polyp has to do with eating habits. However, for other types of polyp, the cause hasn’t yet been found.

담낭용종의 증상

Gallbladder polyp is often found while having medical checkup since there are no apparent symptoms.
However, if accompanied with cholelithiasis, symptoms similar to cholelithiasis, like upper stomach pain or dyspepsia may occur. Along with these symptoms, if weight loss is accompanied, then there is a possibility that it could be malignant polyp.

담석증의 치료?

Cholecystectomy is performed to remove the gallstones

담석증은 언제 수술을 해야하는가

담낭절제술이란?

Removal of the gallbladder through multiple small incisions. Small incision is made either under the right rib cage or in the middle of the upper part of abdomen, and gallbladder is removed. Cholelithiasis cannot be cured by removing the gallbladder stone solely since recurrence is unavoidable without removing the gallbladder.

담낭절제술 후 신체의 변화

Many patients believe that they would feel the differences in the absence of gallbladder. One of the common misconceptions is that they cannot digest properly without gallbladder. Gallbladder is not an organ to produce bile rather an organ to store and release it. Since bile is made in the liver, digestion should not be affected by the surgery.

Another misconception is that you need to take the medicine for a long period. The medication that you take after the operation is to protect liver and dilute the bile, and you need to take them for a short period.

A normal change that you can experience is dyspepsia, and less solid stool which is due to leakage of bile through biliary tract to the large intestine. These are all temporary and will come back to normal status. Overall, there isn’t much physical change that patients experience after cholecystectomy.

담낭절제술의 방법

Before 1990s, laparoscopic surgeries were not introduced so open surgery was commonly performed. However, after this, laparoscopic surgeries were introduced and became the standard procedure for cholelithiasis. After 2000, more advanced, single port laparoscopic cholecystectomy is performed through umbilicus. This can speed up the recovery of the patients, and provide aesthetically satisfying results.

그림-복강경 담낭절제술(복강경 카메라)과 개복 담낭절제술(우상복부 개복)

담낭용종의 진단

It is very easy to find and diagnose Gallbladder polyp with abdominal ultrasonography.
However, it is crucial to determine whether the polyp is malignant or benign. Polyps that develop in the stomach or large intestine can be easily examined with an endoscope and are easy to differentiate. Before the operation, a biopsy cannot be done so the only way to find out if the polyp is malignant is with medical imaging. It is difficult to examine the detailed structure of poly, appearance, and the layer structure of gallbladder wall with abdominal ultrasonography. If concluded that further examination is necessary, endoscope ultrasonography can be done. Also, if there is a high chance of the polyp being malignant, abdominal CT or MIR can be helpful.

For abdominal diagnostic sonography, fasting is mandatory. When we ingest food, stored bile is excreted through the biliary tract causing it to shrink. To have a closer look at the Gallbladder polyp, it needs to be in the state of being inflated. This is why you will fast and go through the examination.

담낭용종의 초음파 소견
There are cholesterol polyp, inflammatory polyp, and proliferative polyp.

[Benign]

The shape is not irregular and the 비후 on the gallbladder wall is not tightening, often in a small size.
초음파사진-양성 담낭용종

[Malignant]

The shape is irregular and shade is irregular as well. Size is often over 1cm
초음파사진-악성 담낭용종
담낭 용종의 내시경 초음파(EUS) 소견
Allows closer examination of the relations between gallbladder wall and polyp and also helps to determine whether it is malignant or not.
사진-담낭용종의 내시경 초음파(EUS) 소견
담낭 용종의 CT 소견
Able to clearly see correlation gallbladder polyp and gallbladder wall For gallbladder carcinoma, it helps to determine the possibility of infiltration.
사진-담낭 용종의 CT 소견

담낭용종의 치료

The only way of treating gallbladder polyp is surgically removing the gallbladder. The purpose of treating gallbladder polyp is the possibility of malignant polyp. Then in what cases are surgerie operated? In 2010, The Korean Association of HBP Surgery introduced the guidelines for management of gallbladder polyps. After countless studies, these guidelines were put together with latest knowledge.

담낭용종 치료권고안

참고사진-담낭 용종 진료 권고안

권고사항 요약:악성 위험인자
권고사항 요약:악성 위험인자
  근거수준
If the size of gallbladder polyp is over 10mm, there is a high chance of it being malignant. 3
The fluctuating size of a gallbladder polyp may mean a higher chance of it being malignant 3
Gallbladder polyp patients 50 years or older have high possibility of malignancy. 3
If the number of gallbladder is just one lesion, there is chance of it being malignant. 3
If shape of polyp is aplastic, although the lesion is 10mm or smaller, there is possibility of it being malignant. 3
Accompanying gallstone increases chance of malignant. 3
도표-담낭용종 치료 권고안에 따른 수술을 고려하는 요인들
The chart above shows that individual should consider undergoing surgery if polyp is over 1cm, the size of polyp fluctuate, accompanies gallstone, or found in patients over 50 years old.
Those who are not applicable to these criteria are observed by ultrasonography for six months interval. At Dam So Yu Hospital, we follow the Practical Guidelines for Management of Gallbladder Polyps by The Korean Association of HBP Surgery when it comes to treatment.
학회발표 학회발표