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Biomedical subjects

T K Choi

Publications and source records attributed to T K Choi.

At least 73 records · Page 4Linked to original sources
PubMed1984

Severe acute pancreatitis caused by parasites in the common bile duct.

Nine cases of acute pancreatitis due to parasites in the common bile duct (Ascaris lumbricoides 4, Clonorchis sinensis 5) are reported. Eight cases were discovered at laparotomy and one at postmortem. The indications for operation were worsening pancreatitis, sepsis or cholangitis. Decompression of the biliary system and removal of parasites resulted in the recovery of the eight cases operated upon. In endemic areas, all patients with acute pancreatitis should be screened for parasites. Antibiotics and/or antihelminthics should be given if they are found. Surgery is necessary for those with worms causing biliary or pancreatic obstruction who do not respond.

Acute Disease↗
PubMed1982

The surgical management of primary intrahepatic stones.

Primary intrahepatic stones are commonly found in association with recurrent pyogenic cholangitis. In 115 patients with this condition, the intrahepatic stones were removed by four different methods: common duct exploration (n = 74), transhepatic intubation (n = 10), hepatotomy (n = 5) and hepatic resection (n = 26). The choice of methods was guided by the location of stones and the condition of the bile ducts and the liver. These extraction procedures were combined with drainage procedures, i.e. sphincteroplasty and choledochojejunostomy, whenever the proper indications were present. The operative mortality was 4.3 per cent. Long term follow-up (median 7 years and 8 months) on 91 patients revealed that common duct exploration, transhepatic intubation and hepatotomy were associated with high incidences of recurrent symptoms requiring reoperation (23.6 per cent, 37.5 per cent and 75 per cent respectively). In most instances, failures were due to recurrent stone formation in the stenotic intrahepatic ducts. Hepatic resection had the lowest failure rate (4.2 per cent) and none of the patients had recurrent stones.

Cholelithiasis↗
PubMed1982

Survival after surgery for advanced carcinoma of the stomach other than the cardia.

The survival of 103 patients operated on for advanced carcinoma of the stomach other than the cardia was assessed. The median duration of survival for patients subjected to palliative partial gastrectomy, total gastrectomy, gastrojejunostomy, and biopsy only was 24, 22, 11, and 10 weeks, respectively. All of these patients had definite residual tumor. In the 27 patients with preoperative signs of incurable tumor, the high operative mortality rate (19 percent), the low rate of resectability (26 percent), and the short duration of survival in the patients who had resection (median 11 weeks) combined lead to the conclusion that exploration for the possibility of resection is not worthwhile.

Aged↗
PubMed1982

Extraperitoneal sphincteroplasty for residual stones: an update.

Sphincteroplasty was done via the extraperitoneal transduodenal approach in 42 patients. The indications were residual stones in 34 patients, stricture at Oddi's sphincter in seven patients, and relapsing pancreatitis in one patient. Seven patients suffered operative complications, with one death. Sphincteroplasty was successfully performed in all patients, and the residual stones were removed in 31. Thirty-three of the 36 patients followed up for a mean of seven years were asymptomatic. Extraperitoneal sphincteroplasty has a role in supplementing endoscopic papillotomy and percutaneous extraction through the T-tube tract in the treatment of patients with residual stones.

Adult↗
PubMed1982

Choledochojejunostomy in the treatment of primary cholangitis.

Choledochojejunostomy was performed upon 128 patients with primary cholangitis with an operative mortality of 2.3 per cent. Evaluation of 106 patients at a median of eight years reveals that 78 patients or 73.6 per cent have good, 14 or 13.2 per cent have fair and 14 or 13.2 per cent have poor results. All 14 patients with poor results required reoperation, and the findings showed that the two most common causes of recurrent symptoms are the reformation of stones, despite a patent choledochojejunostomy and the stricturization of the choledochojejunostomy. When performed with the proper indications, choledochojejunostomy is a safe and effective procedure for managing patients with primary cholangitis.

Adolescent↗
PubMed1981

Late result of sphincteroplasty in the treatment of primary cholangitis.

Sphincteroplasty is one of the surgical procedures used in the treatment of primary cholangitis. We performed this operation on 342 patients over a 13-year period, with an operative mortality of 4.7%. Postoperative examination of 271 patients (average follow-up, seven years four months) showed that a good result was achieved in 226 patients, a fair result in 23 patients, and a poor result in 22 patients. Analysis of the reoperations in 17 patients showed that stone reformation is the most common finding, followed by sphincteroplasty stricture, liver abscess, and empyema of the gallbladder. When performed with proper indications in the management of primary cholangitis, sphincteroplasty is a safe procedure, and the majority of patients can expect good results.

Adult↗
PubMed1981

The surgical management of anorectal malignant melanoma.

The biological vagaries of anal malignant melanoma are illustrated by four cases in Chinese patients. All four died within five years. Their poor prognosis emphasizes the value of preoperative studies to detect clinically occult metastases and obviate futile radical surgery. Many patients already have disseminated disease at the time of diagnosis, and local excision of the tumour provides acceptable palliation. For localized disease, abdominoperineal resection prevents local recurrence and removes the mesenteric nodes which are frequently involved. Palpable inguinal nodes necessitate therapeutic groin dissection, but we perform elective resection only when affected nodes are found at laparotomy. Pelvic lymphadenectomy should be performed in conjunction with abdominoperineal resection. The efficacy of chemotherapy for anorectal melanoma remains uncertain.

Adult↗
PubMed1981

Carcinoma of the colon and rectum with liver involvement.

The records of 126 patients with adenocarcinoma of the colon and rectum who presented with liver involvement were reviewed. Prognosis was determined by the amount of metastases to the liver, which was usually extensive of ascites or a raised alkaline phosphatase level was present. The longest survival period was achieved with resection of the primary tumor along with hepatic lesions confined to a single lobe, especially those due to direct tumor infiltration. If liver deposits were found bilaterally, palliative resection of the primary lesion relieved intestinal symptoms. This may also prolong the survival time, because a fixed primary tumor appeared to diminish the outlook among patients with comparable liver disease. Palliative resection in the presence of ascites resulted in a high mortality, and the survival rate was no better than that after diversion procedures. We recommend resection without anastomosis for carcinoma of the rectosigmoid in patients with ascites and unresectable secondary lesions of the liver.

Adenocarcinoma↗