[Description exercise 4 ÇØ¼³] - ðû

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³»½Ã°æ °á°úÁö´Â °ø¹®¼­ÀÔ´Ï´Ù. ÇÑ±Û ¸ÂÃã¹ýµµ ½Å°æ¾²½Ã±â ¹Ù¶ø´Ï´Ù. EndoTODAY ÇÑ±Û ¸ÂÃã¹ýÀ» ÂüÁ¶Çϼ¼¿ä. °¡Àå ¸¹ÀÌ Æ²¸®´Â °ÍÀº 'µ¤Çô ÀÖ´Ù'ÀÔ´Ï´Ù. 'µ¤¿© ÀÖ´Ù'°¡ ¸Â½À´Ï´Ù.

¿µ¾îµµ ¹ßÀ½À» Àß ÇØ¾ß ÇÕ´Ï´Ù.^^ °¡Àå ¸¹ÀÌ Æ²¸®´Â °ÍÀº '·¹Á¯'ÀÔ´Ï´Ù. Àý´ë ¸ø ¾Ë¾Æµé¾î¿ä.

°øºÎÇÒ ÀÚ·á°¡ ³ÑÄ¡´Â ½Ã´ëÀÔ´Ï´Ù¸¸...... ³»½Ã°æÇÐȸ¼¼¹Ì³ª °­ÀÇ µ¿¿µ»ó°ú KSGE webinar´Â ¾ÆÁÖ ÁÁ½À´Ï´Ù. °­Ãß.

EndoTODAY Quick Reference¸¦ ¼Ò°³ÇÕ´Ï´Ù. ³»½Ã°æ °Ë»ç µµÁß ¸¸³ª´Â ÈçÇÑ ±Ã±ÝÁõ¿¡ ´ëÇÑ ´äº¯À» ¸ð¾ÆµÐ °ÍÀÔ´Ï´Ù.

2022-2-19. Winter School

Áõ·Ê¸¦ Áß½ÉÀ¸·Î ÇÑ °­ÀÇ µ¿¿µ»óÀ» ¸¹ÀÌ º¸½Ã±â ¹Ù¶ø´Ï´Ù. 2020³â °­ÀÇ µ¿¿µ»ó


Áõ·Ê 22

¼Ò°ß: »óºÎ ½ÄµµºÎÅÍ ÇϺνĵµ±îÁö 1-3 mm Å©±âÀÇ ¸¹Àº white plaqueµéÀÌ scattered µÇ¾î ÀÖÀ½. ÇϺΠ½Äµµ¿¡¼­´Â plaque µéÀÌ ¼­·Î À¶ÇյǴ ¸ð½ÀÀ» º¸À̰í ÀÖÀ½. Á¡¸·ÀÇ ºÎÁ¾À̳ª ±Ë¾çÀº °üÂûµÇÁö ¾ÊÀ½.

Áø´Ü: Esophageal candidiasis, grade III


[ÀÌÁØÇà comment]

Candidiasisµµ °¡±ÞÀû gradingÀ» ºÙ¿©ÁÝ´Ï´Ù. ÀÌ °æ¿ì´Â ÀϺΠconfluent ÇϹǷΠgrade III°¡ ÁÁ°Ú½À´Ï´Ù. ¿ì¸®ÀÇ ¿øÄ¢Àº À̰ÍÀÔ´Ï´Ù. ºÐ·ù¹ýÀÌ ÀÖ´Â °ÍÀº ´Ù ºÙ¿©ÁØ´Ù.


[2020-1-16. Çлý Áú¹®] Case 22 °æ¿ì ¾î¶² classification À¸·Î ½á¾ßÇÒÁö ¸ð¸£°Ú½À´Ï´Ù.

[2020-1-17. ÀÌÁØÇà ´äº¯] ºÐ·ù°¡ ´Ù¼Ò ¾Ö¸ÅÇÑ Áõ·ÊÀÔ´Ï´Ù. 2¿Í 3 »çÀ̶ó°í »ý°¢µÇ´Âµ¥... º¸Åë °¡±î¿î ÂÊÀ¸·Î ÁßÁõµµ ºÐ·ù¸¦ Çϴµ¥... »óºÎ ½Äµµ´Â grade 2¿¡ °¡±î°í ÇϺΠ½Äµµ´Â grade 3¿¡ °¡±õ½À´Ï´Ù. À̸¦ Á¾ÇÕÇÏ¿© Àú´Â grade 3À¸·Î ºÙ¿©º¸¾Ò½À´Ï´Ù.

* Âü°í: EndoTODAY ½Äµµ ĵµð´ÙÁõ


Áõ·Ê 23

¼Ò°ß: ÇϺνĵµ¿¡ 5-6 mm Å©±âÀÇ Á¤»óÁ¡¸·À¸·Î µ¤ÀΠȲ»öÀÇ flat elevated ÇüÅÂÀÇ »óÇÇÇÏ Á¾±«°¡ °üÂûµÊ

Áø´Ü: esophageal submucosal tumor (most likely, granular cell tumor)


[ÀÌÁØÇà comment]

Granular cell tumorÀÔ´Ï´Ù. Carcinoidµµ ºñ½ÁÇÏ°Ô º¸ÀÏ ¼ö ÀÖ½À´Ï´Ù. ½Äµµ¿¡¼­´Â carcinoid¿¡ ºñÇÏ¿© granular cell tumor°¡ ÈçÇϰí À§³ª ´ëÀå¿¡¼­´Â ´ëºÎºÐ carcinoidÀÔ´Ï´Ù. °£È¤ leimyoma¶ó°í ´äÇÑ ºÐÀÌ °è½Ê´Ï´Ù¸¸... granulcar cell tumor¿Í carcinoid´Â Á¡¸·º´¼ÒÀ̹ǷΠ¾à°£ Åõ¸íÇÏ°Ô ºñÄ¡´Â ¹Ý¸é leiomyoma´Â ´ëºÎºÐ Á¡¸·ÇÏ º´¼ÒÀ̹ǷΠÁ¾¾çÀÌ Åõ¸íÇÏ°Ô ºñÄ¡´Â °æ¿ì´Â °ÅÀÇ ¾ø½À´Ï´Ù.

* Âü°í: EndoTODAY ½Äµµ °ú¸³¼¼Æ÷Á¾


Áõ·Ê 24. Gastric antrum

¼Ò°ß: ÀüÁ¤ºÎ Àü¹Ý¿¡ °ÉÃÄ goose skin appearance (´ß»ì ¸ð¾ç) multiple small nodular lesion µéÀÌ »êÀçµÇ¾î ÀÖÀ½. º´¼ÒµéÀÇ Å©±â¿Í ¸ð¾çÀº 1-2 mm Á¤µµ·Î ºñ±³Àû ÀÏÁ¤ÇÔ.

Áø´Ü: Lymphofollicuar gastritis (= nodular gastritis), small granular type


[ÀÌÁØÇà comment]

¾î¶² Àü°øÀÇ ¼±»ý´ÔÀÇ Áú¹®°ú ÀúÀÇ ´äº¯À» ¼Ò°³ÇÕ´Ï´Ù. ±×·¸½À´Ï´Ù. ÃʽÉÀÚ ÀÔÀå¿¡¼­´Â lymphofollicular gastritis¿Í metaplastic gastritis°¡ ºñ½ÁÇØ º¸ÀÏ ¼ö ÀÖÀ» °Í °°½À´Ï´Ù.

Áø´Ü¸í¿¡ ´ëÇÑ ³í¶õÀÌ ÀÖ½À´Ï´Ù¸¸ Àú´Â nodular gastritis¶ó´Â ÀϺ»½Ä ¿ë¾îº¸´Ù´Â lymphofollicular gastritis¶ó´Â º¸´Ù ÀüÅëÀûÀÎ ¿ë¾î¸¦ ´õ ÁÁ¾ÆÇÕ´Ï´Ù. ¸²Æ÷¿©Æ÷¼º À§¿°Àº ³»½Ã°æ¿¡¼­ ´ß»ì ¸ð¾ç(¿µ¾î·Î´Â goose-skinÀ̶ó°í ºÎ¸¨´Ï´Ù)ÀÇ ÀÛÀº °áÀýµéÀÌ ÀüÁ¤ºÎ¿Í À§Ã¼ÇϺο¡¼­ °üÂûµË´Ï´Ù. Á¶Á÷°Ë»ç¿¡¼­´Â (1) ¸²ÇÁ¿©Æ÷ Çü¼º°ú (2) ¼±¿Í»óÇÇ °úÇü¼º ¼Ò°ßÀÌ °üÂûµË´Ï´Ù.

ÀþÀº ¿©¼º¿¡¼­ ÈçÇϸç Helicobacter pylori °¨¿°¿¡ µû¸¥ ¸é¿ª¹ÝÀÀÀÇ °á°ú·Î ÃßÁ¤µÇ°í ÀÖ½À´Ï´Ù. ³í¶õÀÌ ÀÖÁö¸¸ ¾Ï¹ß»ýÀÇ °íÀ§Çè »óȲÀ¸·Î ÇØ¼®µÇ´Â °æÇâÀÌ ÀÖ°í, Á¦±ÕÄ¡·á¸¦ ÇÏ´Â °ÍÀÌ ÁÁ°Ú½À´Ï´Ù. ¾Æ·¡´Â À¯»ç Áõ·ÊµéÀÔ´Ï´Ù.

Lymphofollicular gastritis¸¦ small granular type°ú large nodular typeÀ¸·Î ³ª´©±âµµ ÇÕ´Ï´Ù. Àú´Â small granular typeÀ¸·Î ÇØ¼®Çß½À´Ï´Ù.

ÀϺ»¿¡¼­´Â ÈçÈ÷ °áÀý¼º À§¿°(nodular gastritis)À̶ó°í ºÎ¸£°í ÀÖ°í ¿ì¸®³ª¶ó ³»½Ã°æÃ¥¿¡¼­µµ °áÀý À§¿°À̶ó´Â ¿ë¾î°¡ º¸ÀÔ´Ï´Ù (¾Æ·¡ ±×¸²). Àú´Â lymphofollicular gastritis¶ó°í ¾²´Â ÆíÀÔ´Ï´Ù. ±¹Á¦ÀûÀ¸·Î Á» ´õ Á߸³ÀûÀÎ ¿ë¾î¶ó°í »ý°¢Çϴϱî¿ä. ¿©ÇÏÆ° lymphofollicular gastritis ȤÀº nodular gastritis, ¾î´À ¿ë¾î¸¦ »ç¿ëÇØµµ »ó°ü ¾ø½À´Ï´Ù.

Hp °Ë»ç°¡ ÇÊ¿äÇÑÁö ¹®ÀÇÇϽм±»ý´ÔÀÌ °è¼Ì½À´Ï´Ù. Àú´Â Hp °Ë»ç¸¦ Çϰí ÀÖÀ¸¸ç, È®ÀεǸé Á¦±ÕÄ¡·á¸¦ ÇÕ´Ï´Ù. °ú°Å¿¡´Â »è°¨ ¿ì·Á°¡ ÀÖ¾úÀ¸³ª 2018³â 1¿ù 1ÀϺÎÅÍ´Â ÀÌ·± °æ¿ì 100/100 ºñ±Þ¿©·Î ó¹æÇÒ ¼ö ÀÖ°Ô µÇ¾ú½À´Ï´Ù.

¾Æ·¡ µ¿¿µ»óÀ» º¸½Ã±â ¹Ù¶ø´Ï´Ù.

Helicobacter 2022

* Âü°í 1): EndoTODAY Lymphofollicular gastritis

* Âü°í 2): EndoTODAY Ç︮ÄÚ¹ÚÅÍ À§¿°


Áõ·Ê 25

¼Ò°ß: (1) À§°¢ÀÇ ¼Ò¸¸¿¡, (2) 4x3 cm Å©±âÀÇ, (3) flat elevated lesionÀÌ ÀÖ½À´Ï´Ù. (4) º´º¯ÀÇ °æ°è´Â ºñ±³Àû ¸íÈ®Çϰí, Ç¥¸éÀº ¾à°£ paleÇϸ鼭 nodularÇÕ´Ï´Ù. ÇÔ¹°ºÎ³ª ÁÖ¸§ º¯È­´Â ¾ø½À´Ï´Ù.

Áø´Ü: Gastric adenoma, r/o EGC IIa


[ÀÌÁØÇà comment]

À§¾Ï°ú ¼±Á¾ÀÇ ±¸ºÐÀÌ ¾î·Á¿î Áõ·ÊÀÔ´Ï´Ù. µÎ Áø´Ü Áß ¾î´À °ÍÀÌ ¿ÇÀºÁö ¸íÈ®ÇÏÁö ¾ÊÀ» ¶§ ¾î¶»°Ô Áø´Ü¸íÀ» ºÙ¿©¾ß ÁÁÀ»Áö °í¹ÎÀÔ´Ï´Ù. ¾î´À ÂÊÀÇ °¡´É¼ºÀÌ ´õ ³ôÀºÁö »ý°¢Çغ¸¸é ¾î¶³±î¿ä? ±×·¡¼­ Áø´Ü¸í¿¡ 'µÑ ´Ù °¡´ÉÇѵ¥, ¾î´À ÂÊÀÇ °¡´É¼ºÀÌ ´õ ³ô´Ù'´Â °ÍÀ» ¸íÈ®È÷ Ç¥ÇöÇÏ´Â °ÍÀÌÁö¿ä. ¸¹Àº ÈÆ·ÃÀÌ µÉ °ÍÀÔ´Ï´Ù. ¾î´À Àü°øÀÇ¿¡°Ô ´äÇÑ ³»¿ëÀ» ¼Ò°³ÇÕ´Ï´Ù.

°£È¤ metaplasia¶ó°í ´äÇϽô ºÐÀÌ °è½Ã´Âµ¥ ÀÌ Á¤µµ¸é ºÐ¸íÈ÷ flat elevated neoplastic lesionÀÔ´Ï´Ù.

ESD¸¦ ÇßÀ¸¸ç ÃÖÁ¾ º´¸®°á°ú´Â tubular adenoma, 3 x 3.5 cm, negative resection marginÀ̾ú½À´Ï´Ù.

À§ ¼±Á¾¿¡ ´ëÇÑ ¾Æ·¡ µ¿¿µ»óÀ» ²À º¸½Ã±â ¹Ù¶ø´Ï´Ù.

* Âü°í: EndoTODAY ¼±Á¾/ÀÌÇü¼º


Áõ·Ê 26

¼Ò°ß: À§Ã¼ÇϺΠÀüº®¿¡ ¾à 4cm Å©±âÀÇ °æ°è°¡ ºÒºÐ¸íÇϰí Ç¥¸éÀÌ ºÒ±ÔÄ¢ÇÑ ¹ßÀû°ú Åð»öÀÌ È¥ÀçÇÑ ¿µ¿ªÀÌ ÀÖÀ½. ¿©·¯ ¹æÇâ¿¡¼­ Á¡¸·ÁÖ¸§ÀÌ ²ø·Á¿À°í ÀÖÀ¸¸ç º´¼ÒÀÇ °æ°è ºÎ±Ù¿¡¼­ ²÷±è.

Áø´Ü: EGC IIb


[ÀÌÁØÇà comment]

Superfial flat lesionÀÌ°í ºÒ±ÔÄ¢ÇÏ°Ô hyperemicÇÑ Ç¥¸éÀÔ´Ï´Ù. ÁÖ¸§ÀÌ ²ø·Á¿À´Â °ÍÀº ÇÔ¸ôÇü º´¼ÒÀÇ Æ¯Â¡ÀÌÁö¸¸ ÀÌ È¯ÀÚÀÇ °æ¿ì ½ÇÁ¦·Î ÇÔ¸ô·Î º¸ÀÌÁö ¾ÊÀ¸¹Ç·Î EGC IIb¸¦ ÁÖ´Â °ÍÀÌ ¹«³­ÇϰڽÀ´Ï´Ù.

ÀÌ È¯ÀÚ´Â ³»½Ã°æ Á¶Á÷°Ë»ç ÈÄ ÃâÇ÷ÀÌ ¹ß»ýÇÏ¿© ³»½Ã°æ Àç°ËÀ» ÇÏ¿´´ø ºÐÀÔ´Ï´Ù. Á¶Á÷°Ë»ç ÈÄ °£È¤ ÃâÇ÷ÀÌ ¹ß»ýÇÒ ¼ö Àִµ¥ À§¾ÏÀÇ °æ¿ìµµ ¿¹¿Ü´Â ¾Æ´Õ´Ï´Ù.

³»½Ã°æ ¹× Á¶Á÷°Ë»ç ÈÄ melena¸¦ º¸¿© ½ÃÇàÇÑ ³»½Ã°æ¿¡¼­ ¶Ñ·ÇÇÑ ±Ë¾çÀÌ °üÂûµÇ¾ú½À´Ï´Ù. Á¶Á÷°Ë»ç·Î ÀÎÇÑ º¯È­ÀÔ´Ï´Ù.

¼ö¼úÀ» ÇÏ¿´°í ÃßÁ¤ÇÏ¿´´ø °Íº¸´Ù Å« °ÍÀ¸·Î ³ª¿Ô½À´Ï´Ù. Signet ring cell carcinoma¿¡¼­ ÈçÈ÷ ÀÖ´Â ÀÏÀÔ´Ï´Ù.

Early gastric carcinoma
1. Location : middle third, center at body and anterior wall
2. Gross type : EGC type IIb
3. Histologic type : signet-ring cell carcinoma
4. Histologic type by Lauren : indeterminate
5. Size : 6.5x3.3 cm
6. Depth of invasion : extension to mucosa (muscularis mucosa) (pT1a)
7. Resection margin: free from carcinoma, safety margin: distal 5.2 cm, proximal 4 cm
8. Lymph node metastasis : no metastasis in 33 regional lymph nodes (pN0)
9. Lymphatic invasion : not identified
10. Venous invasion : not identified
11. Perineural invasion : not identified

ÀÌ·¸°Ô Á¤¸®ÇØ º¾½Ã´Ù. EGC IIb´Â ùÀλ󺸴٠ũ´Ù!!!

EGC ºÐ·ùÀÇ ¸ðÈ£¼º¿¡ ´ëÇØ¼­´Â ÀÏÀü¿¡ ¼³¸íµå¸° ¹Ù ÀÖ½À´Ï´Ù. IIb´Â flatÇÑ ÇüÅÂÀε¥, ±×·¸´Ù¸é fold´Â ¾ø¾î¾ß ÇÏ´Â °Í ¾Æ´Õ´Ï±î? ±×·±µ¥ ½ÇÁ¦·Î´Â fold º¯È­°¡ ÀÖ´Â EGC IIbµµ ÀÖ½À´Ï´Ù. ¿©ÇÏÆ° EndoTODAY Á¶±âÀ§¾Ï ³»½Ã°æ ºÐ·ù¸¦ õõÈ÷ Àо½Ã±â ¹Ù¶ø´Ï´Ù.

PPT PDF 0.4 M


Áõ·Ê 27

¼Ò°ß: À§Ã¼ÇϺΠ(À§°¢ Á÷»óºÎ) ¼Ò¸¸-Àüº®¿¡ 3-4cm Å©±âÀÇ À¶±âµÈ º¯¿¬À» °¡Áø ±Ë¾çÀÌ °üÂûµÊ. ±Ë¾çÀÇ edge´Â geographicÇϰí spiculationÀ» º¸À̸ç, ±Ë¾çÀÇ ¹Ù´ÚÀº ºñ±³Àû flatÇϰí exudate·Î µ¤¿© ÀÖÀ½.

Áø´Ü: EGC IIa+III


[ÀÌÁØÇà comment]

¾ÏÀÎÁö ¾ç¼º ±Ë¾çÀÎÁö ¾Ö¸ÅÇÒ ¶§ °á°ú¸¦ ¾î¶»°Ô ½á¾ß ÇÏ´ÂÁö Áú¹®ÀÌ À־ ¾Æ·¡¿Í °°ÀÌ ´äÇÏ¿´½À´Ï´Ù. »ç½Ç ÀÌ È¯ÀÚ´Â ¾ÏÀÌ È®½ÇÇÑ °æ¿ì¿´Áö¸¸....

DEX workshop °­ÀÇ·Ï Áß¿¡¼­

'Ulcer with marginal edema/thickening'À¸·Î º¼ ¼öµµ ÀÖ°í 'mass with central irregular ulcer'·Î º¸´Â °Íµµ °¡´ÉÇÒ °Í °°½À´Ï´Ù. ¾î´À °ÍÀÌ ´õ Àû´çÇÒÁö °í¹ÎÇØ º¾½Ã´Ù.

À§¾ÏÀÇ ½É´Þµµ Áø´ÜÀº ½±Áö ¾Ê½À´Ï´Ù. 80% ¸ÂÃß¸é ³ª»ÚÁö ¾ÊÀ» Á¤µµÀÔ´Ï´Ù. EndoTODAY À§¾Ï ½É´Þµµ Áø´ÜÀ» ²À Àо½Ã±â ¹Ù¶ø´Ï´Ù.

EGC IIa + III°¡ ´õ ÁÁÀ»Áö IIa + IIc°¡ ´õ ÁÁÀ»Áö Àúµµ Àß ¸ð¸£°Ú½À´Ï´Ù. IIc·Î ºÙÀ̱⿡´Â ±í°í, III·Î ºÙÀ̱⿡´Â ¾èÀº °Í °°°í... »ç½Ç ÀÌ·± Áõ·Ê°¡ ¸Å¿ì ¸¹½À´Ï´Ù. ¼ö¼úÀ» ÇÏ¿´°í »ý°¢º¸´Ù ±íÀº °ÍÀ¸·Î, mass lesionÀ̸鼭 Áß¾Ó¿¡ ±Ë¾çºÎ°¡ µ¿¹ÝµÈ °ÍÀ¸·Î ³ª¿Ô½À´Ï´Ù. º´¸®°á°ú¸¦ º¸°í ÈÄÇâÀûÀ¸·Î »ý°¢Çغ¸¸é º´¼ÒÀÇ ÁÖµÈ Æ¯Â¡ÀÌ ±Ë¾çÀÌ ¾Æ´Ï°í °æ°è°¡ ¸íÈ®ÇÏÁö ¾ÊÀº ³ÐÀº mass·Î º¼ ¼öµµ ÀÖ°Ú´Ù´Â »ý°¢ÀÌ µì´Ï´Ù. ÃßÁ¤Çß´ø °Íº¸´Ù ÈξÀ Å« °ÍÀ¸·Î ³ª¿Ô½À´Ï´Ù.^^

Advanced gastric carcinoma, mimicking EGC type IIb+IIc, low body along the lesser curvature,
Adenocarcinoma, poorly differentiated, diffuse type;
1) tumor size: about 8x4.5 cm
2) extension to the subserosa
3) no endolymphatic tumor emboli
4) negative resection margins (proximal: about 3 cm; distal: about 3 cm)
5) no metastasis in 48 perigastric lymph nodes

* Âü°í: EndoTODAY À§¾Ï ħÀ± ±íÀÌ

* Âü°í: ¾à°£ ´Ù¸£Áö¸¸ ´ÙÀ½ ÀÚ·áµµ »ìÆìº¸½Ã¸é ÁÁÀ» °Í °°½À´Ï´Ù. Áõ·Ê·Î »ìÆìº¸´Â À§¾ÏÀÇ Ä§À± ±íÀÌ Wall thickening mass with converging folds


Áõ·Ê 28 - ½ÊÀÌÁöÀå

¼Ò°ß: (1) ½ÊÀÌÁöÀå 2ºÎ¿¡, (2) 4-5 cm Å©±âÀÇ (3) ulcerative lesionÀÌ º¸ÀÔ´Ï´Ù. (4) ±Ë¾çÀÇ ¹Ù´ÚÀº necroticÇϰí dirty exudate·Î µ¤¿©ÀÖÀ¸¸ç, edge´Â ºñ±³Àû ¸í·áÇÏÁö¸¸ marginÀº heaped up µÇ¾î ÀÖ½À´Ï´Ù.

Áø´Ü: Duodenal cancer


[ÀÌÁØÇà comment]

±Ë¾çÀ¸·Î ´äÇϽŠºÐÀÌ Àý¹Ý Á¤µµ¿´´Âµ¥¿ä... ½ÊÀÌÁöÀåµµ ¾ÏÀÌ ÀÖÀ½À» ÀØÁö ¸¶¼¼¿ä.

¼ö¼ú °á°ú´Â ¾Æ·¡¿Í °°¾Ò½À´Ï´Ù.

PERIAMPULLARY DUODENAL CANCER
1. Type of specimen : Whipple resection
2. Histopathologic Diagnosis : Adenocarcinoma, M / D
(1) Tumor site : duodenal
(2) Tumor size : 6x4 cm
(3) T3 : Tumor invades pancreas and periduodenal adipose tissue
(4) Involvement of pancreas and duodenum : present
(5) N1 : Regional lymph node metastasis (2/5: "LN8", 0/2; "LN12", 0/1; peripancreatic lymph node, 2/2(dNi))
(6) M0 : No distant metastasis
(7) Negative resection margins (R0 : complete resection with grossly and microscopically negative resection margins)
(8) perineural invasion: present
(9) lymphovascular invasion: present
(10) mucin production: irregular
(11) pancreas autolysis, moderate
(12) autolysis: gallbladder

¾Æ·¡ ½ÊÀÌÁöÀå ¾Ï »çÁøµéÀ» Àß ºÁ µÎ¼¼¿ä.

°¡Àå Áß¿äÇÑ Áõ·ÊÀÔ´Ï´Ù!!! ¸î ¹øÀÇ Á¶Á÷°Ë»ç¿¡¼­ ¾ÏÀ¸·Î ³ª¿ÀÁö ¾Ê¾Æ Áø´ÜÀÌ ´Ê¾îÁ³´ø Áõ·ÊÀÔ´Ï´Ù. ÀÌ·± Á¤µµÀÇ ¼Ò°ßÀÌ º¸À̸é Á¶Á÷°Ë»ç¿¡¼­ ¾ÏÀÌ ³ª¿ÀÁö ¾Ê¾Æµµ ¹Ýµå½Ã, ¹Ýµå½Ã ¾ÏÀ» ÀǽÉÇØ¾ß ÇÕ´Ï´Ù.

M/D adenocarcinoma, 3.5 x 3 cm, extension to subserosa, metastasis to 3 out of 10 regional lymph nodes

Obstruction (+), hepatic metastasis (+)

Bowel habit change·Î ´ëÀå³»½Ã°æ¿¡¼­ ¿ìÃø ´ëÀå¾ÏÀÌ ¹ß°ßµÇ¾ú°í ¿ì¿¬È÷ ½ÃÇàÇÑ À§³»½Ã°æ¿¡¼­ duodenal adenocarcinomaµµ ÇÔ²² Áø´ÜµÇ¾úÀ½. Whipple ¼ö¼ú°ú right hemicolectomy¸¦ µ¿½Ã¿¡ ½ÃÇàÇÏ¿´À½.

¿ÜºÎ ³»½Ã°æ¿¡¼­ "duodenal 3rd part ulcer and stricture (biopsy: atypical glands)" ¼Ò°ßÀ¸·Î ÀÇ·ÚµÈ ºÐÀ¸·Î ³»½Ã°æ Àç°Ë¿¡¼­ M/D adenocarcinoma·Î ¼ö¼úÇÑ Áõ·ÊÀÔ´Ï´Ù. ³»½Ã°æ ¼Ò°ß°ú ¼ö¼ú º´¸®¸¦ ¼Ò°³ÇÕ´Ï´Ù.
³»½Ã°æ ¼Ò°ß: Duodenal 2nd to 3rd portionºÎÀ§¿¡ lumenÀ» encirclingÇÏ´Â mass °üÂûµÇ¾úÀ¸¸ç ¼Ò¾Æ¿ë ´ëÀå ³»½Ã°æÀ» ÀÌ¿ëÇÏ¿© ÁøÀÔ ½ÃµµÇÏ¿´À¸³ª massÀÇ À§Ä¡°¡ angulation Á÷ÈÄÀ̰í lumenÀÌ Á¼¾ÆÁ®ÀÖ¾î scopeÀÌ Åë°úµÇÁö ¸øÇß½À´Ï´Ù. À§³»½Ã°æÀ¸·Î ¹Ù²Ù¾î tryÇßÀ¸³ª ÃÖ´ëÇÑ »ðÀÔÇØµµ massÀÇ ÀÔ±¸±îÁö ¹Û¿¡ µµ´ÞÇÏÁö ¸øÇÏ¿©, ´Ù½Ã ¼Ò¾Æ¿ë ´ëÀå³»½Ã°æ¿¡ capÀ» ÀåÂøÈÄ tryÇßÀ¸³ª ¿ª½Ã ÁøÀÔºÒ°¡´ÉÇÏ¿© ÃÖ´ëÇÑ forceps¸¦ ¹Ð¾î³Ö¾î Á¶Á÷°Ë»ç¸¦ ½ÃÇàÇß½À´Ï´Ù.
DUODENAL CANCER
1. Type of specimen : PPPD
2. Histopathologic Diagnosis : Adenocarcinoma, moderately differentiated
(1) Tumor site : duodenal
(2) Tumor size : 4.5x4 cm
(3) T3 : Tumor invades through the muscularis propria into the subserosa
(4) Involvement of pancreas: absent
(5) N1 : Regional lymph node metastasis (2/16: "peri-SMA tissue" for frozen section-1, 0/1; "LN8,12", 0/6; "periCBD&peripancreatic LN", 1/3; periduodenal, 1/2; peripancreatic, 0/4)
(6) M0 : No distant metastasis
(7) Negative (pancreas, common bile duct, retropancreatic) resection margins

EndoTODAY 'À§³»½Ã°æ »ðÀÔ°ú °üÂû' 193ÂÊÀ» Âü°íÇϽʽÿÀ.

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2022-72. ¿ëÁ¾ÀýÁ¦¼ú µµ±¸. ¼º°á ±³¼ö´Ô

2022-71. ºñ¿ÂµÚ Á¤ÁøÈñ¼î Ã⿬

2022-12-6

2022-70 ³»½Ã°æ µ¹¾Æº¸±â, ½ÊÀÌÁöÀå ¸²ÇÁÁ¾ (ÀÌÁØÇà)

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2022-69. ³»½Ã°æ ÀÇ»çÀÇ ±Ù°ñ°Ý°è ÀÌ»ó. KDDW 2022 (ÀÌÁØÇà)

2022-68. À§¿°, gastritis (½Å¿î°Ç ±³¼ö´Ô)

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2022-67. 2023³â ½ÅÀÓ GI Fellow¸¦ À§ÇÑ DEX

2022-66. À§½ÄµµÁ¢ÇպξÏÀÇ Siewert ºÐ·ù

2022-65. ±Þ¸¸¼º È£Èí±âÁúȯÀÚÀÇ ³»½Ã°æ. ³ë¿øÀ»Áöº´¿ø À̺´ÈÆ

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2022-62. ÀÚ°¡¸é¿ªÀ§¿°. ¾È¿ëȯ

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2022-61. Bleeding after ESD. Nextbiomedical symposium

2022-60. Endoscopy ergonomicx. SGI

2022-59. Á¦1ȸ ESD Áý´ãȸ 2022³â 10¿ù 11ÀÏ

2022-58. ESD training in Korea - 20221111 Pentax Forward Academy

2022-57. ´ÚÅͺô Helicobacter symposium - (1) Hp Á¦±ÕÄ¡·á¿Í FD Áõ»ó°³¼± È¿°ú (¹ÚÁ¤È£) (2) Hp Á¦±ÕÄ¡·á¿Í À§¾Ï¹ß»ý°úÀÇ ¿¬°ü¼º (Á¤À±¼÷) (3) ÁÂÀå Áõ·Ê ÅäÀÇ (ÀÌÁØÇà)

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2022-56. IBD dysplasia (¾çµ¿ÈÆ ±³¼ö´Ô) - ¿°Áõ¼º ÀåÁúȯ, DALM, Surveillance

2022-55. Sessile serrated lesions ¹«°æ¼º Åé´Ïº´º¯ÀÇ ³»½Ã°æ Áø´Ü ¼ú±â (±èÇö°Ç ±³¼ö´Ô)

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2022-54. Á÷½Ã°æ °Ë»ç¿¡¼­ ³õÄ¡±â ½¬¿î ½ÊÀÌÁöÀå ¹× À¯µÎºÎ Áúȯ (Á¶ÀçÈñ ±³¼ö´Ô)

2022-53. Endoscopic treatment of gastric cancer (ÀÌÁØÇà, KINGCA2022)

2022-52. À§Àå°üÃâÇ÷ÀÇ ÀÀ±Þ³»½Ã°æ (±èÁöÀº ±³¼ö´Ô)

2022-51. ±â´É¼º ¼ÒÈ­ºÒ·®Áõ (È«ÁöÅà ±³¼ö´Ô)

2022-50. Submucosal invasion in forceps biopsy

2022-49. GI intervention, lymphatic approach (Çöµ¿È£ ±³¼ö´Ô)

2022-48. Patient-specific GI route. Stent and PEG (±èÅÂÁØ ±³¼ö´Ô)

2022-47. CT ³»½Ã°æ. CT gastroscopy (Á¤¿ì°æ ±³¼ö´Ô)

2022-46 Helicobacter 2022

2022-45 ESD knife (°ø¼º¹Î ±³¼ö´Ô)

2022-44 Fexuprazan

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2022-43. Atypia. Atypical glands. Atypical cells. ºñÀüÇüÀû ¼Ò°ß. ÀÎõ½Ã³»°úÀÇ»çȸ

2022-42. Koken simulator¸¦ ÀÌ¿ëÇÑ ³»½Ã°æ »ðÀÔ°ú °üÂû. Á¦66ȸ ³»½Ã°æ¼¼¹Ì³ª (2022-8-21)

2022-41. À§Àå°ü ±â»ýÃæ (2022) SMC ¼ÒÈ­±âº´ ½ÉÆ÷Áö¾ö

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2022-40. °íÁ֯Ĺ߻ýÀåÄ¡. Electrosurgical Unit. ESU (±è¹ÎÁö ±³¼ö´Ô)

2022-39. Endoscopic snares (¼º°á ±³¼ö´Ô)

2022-38. ¹ÌºÐÈ­ Á¶Á÷Çü Á¡¸·¾ÏÀÇ ¸²ÇÁÀý ÀüÀÌ Áõ·Ê (2022-6-19. Live pig ESD hands-on training. ¿Ã¸²Çª½º ¼Ûµµ K-TEC training center)

2022-37. Preparation of figures (2022-6-11. IDEN 2022)

2022-36. Áõ·Ê·Î »ìÆìº¸´Â ¼ÒÈ­¼º±Ë¾ç. ÀÌÁØÇà. ºÎ»ê¿¡¼­

2022-35. Seoul Consensus on GERD (¹ÚÂùÇõ ±³¼ö´Ô)

2022-34. ³»½Ã°æ ÁöÇ÷µµ±¸ (À̵¿±Ô ±³¼ö´Ô)

2022-33. Helicobacter treatment for MALT lymphoma. MALToma Ä¡·á (ÀÌÇõ ±³¼ö´Ô)

Á¦15ȸ SMC ³»½Ã°æ¼¼¹Ì³ª - Single topic symposium on gastric MALToma

2022-32. Endoscopic diagnosis of MALT lymphoma. MALToma ³»½Ã°æ Áø´Ü (¼º°á ±³¼ö´Ô)

Á¦15ȸ SMC ³»½Ã°æ¼¼¹Ì³ª - Single topic symposium on gastric MALToma

2022-31. ESD ¼Ò°³. ESD knife¿Í ESU¸¦ Áß½ÉÀ¸·Î.

2022-30. Drug-induced gastropathy. ¼ÒÈ­¼º±Ë¾ç Áõ·Ê ÅäÀÇ

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2022-28. È£Èí±âÁúȯ°ú GERD (À̺´ÈÆ ±³¼ö´Ô)

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2022-27 Esophageal varix (¿ÀÁÖÇö ±³¼ö´Ô)

2022-26 KSGE Web-seminar. ¼ÒÈ­¼º±Ë¾ç Áõ·ÊÅäÀÇ. ±èÁ¤È¯, ±èÅÂÁØ, ÀÌÁØÇà

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2022-25. Single topic symposium on esophageal varix grading °í¸íÁö, ¹Ú¿¹¿Ï

F1 (linear, < 5mm)°ú F2 (beaded or tortuous, >5mm)ÀÇ ±¸ºÐÀÌ ¾Ö¸ÅÇϸé F1À¸·Î ÁØ´Ù. ¾à°£ beaded ÇÑ ¸ð¾çÀÌ´õ¶óµµ 5mm ¹Ì¸¸À̸é F1À¸·Î ÁØ´Ù.

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2022-24. Salvage surgery after ESD for EGC in the elderly

2022-4-9. ¼Ûµµ Olympus K-TEC

2022-23. Case review. EGC with venous invasion

2022-4-9. ¼Ûµµ Olympus K-TEC

2022-22. ¼ÒÈ­±â Áúȯ¿¡¼­ ¿Ã¹Ù¸¥ Ç×»ýÁ¦ »ç¿ë (°­Ã¶ÀÎ ±³¼ö´Ô)

2022-21. À§¿°. ´ëÀå³»½Ã°æ»ðÀÔ¹ý

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2022-20. Extrapulmonary paragonimiasis

2022-19. Endoscope. Low dose PPI for gastritis. Neuroendocrine tumor.

2022-18. À§»óÇÇÇÏÁ¾¾ç. GIST¿Í °¨º°Áø´Ü

2022-17. (1) ±Ë¾çÀΰ¡ ¹Ì¶õÀΰ¡? (2) ±Ë¾çÀΰ¡ ¾ÏÀΰ¡? (3) Refractory GERD&FDÀÇ Ä¡·á¿É¼Ç. ¼­¿ï´ë À̵¿È£ ±³¼ö´Ô°ú ÇÔ²². ´ÚÅͺô web-seminar

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2022-16. In depth case analysis - EGC IIc Ä¡·á¹æÄ§ °áÁ¤. À§Áúȯ³»½Ã°æ¾ÆÆ²¶ó½º Åä·Ð ¸ðÀÓ. 2022-3-7

2022-15. 2022³â 3¿ù 20 (ÀÏ) ³»½Ã°æÇÐȸ¼¼¹Ì³ª °­ÀÇ . ¾ÈÀüÇÏ°í Æí¾ÈÇÑ ³»½Ã°æ »ðÀÔ¹ý°ú º´º¯À» ³õÄ¡Áö ¾Ê±â À§ÇÑ °üÂû¹ý

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2022-13. 2022-2-19. Winter School. ¿°Áõ¼º ÀåÁúȯ (±è¿µÈ£ ±³¼ö´Ô)

2022-13. 2022-2-19. Winter School.ÇϺÎÀ§Àå°üÃâÇ÷ (È«¼º³ë ±³¼ö´Ô)

2022-12. 2022-2-19. Winter School. À§¾ÏÀ» ³õÄ¡Áö ¾Ê´Â ³»½Ã°æ °üÂû¹ý (±èÅÂÁØ ±³¼ö´Ô)

2022-11. 2022-2-19. Winter School. Quick Reference (ÀÌÁØÇà)

2022-10 À̳뿣 ³»½Ã°æ ¾ÆÆ²¶ó½º Åä·Ð¸ðÀÓ. Angiodysplasia. Neuroendocrine carcinoma

2022-9 5¿ù 22ÀÏ À§´ëÀå³»½Ã°æÇÐȸ on-line Çмú´ëȸ. »óºÎÀ§Àå°ü Áõ·Ê

2022-8 [Case] ESD for signet ring cell carcinoma (M/46)

2022-7 À§¾ÏÀÇ ¿¹¹æ (¼­½ÂÀÎ ±³¼ö´Ô)

2022-6 Laryngopharyngeal reflux disease (LPRD) ¼­¿ï´ë À̺ñÀÎÈİú Á¤¿ìÁø

2022-5 (1) GERDÀÇ ÃֽŠÁö°ß, (2) Helicobacter Á¦±ÕÄ¡·á ÈÄ ¹ß°ßµÈ À§¾Ï (3) NK cell (Á¶´ö)

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2022-4 (1) GERDÀÇ ÃֽŠÁö°ß, (2) Would you do ESD? (3) ¼öÇ÷

2022-3 (1) ±×°ÍÀÌ ¾Ë°í½Í´Ù, ¼ÒÈ­±â ³»°ú Áø·áÇöÀå¿¡¼­ ³ª¿Â ¾à¸®Çп¡ °üÇÑ Áú¹®µé, (2) GERDÀÇ ³»½Ã°æ Áø´Ü

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© ÀÏ¿ø³»½Ã°æ±³½Ç ¹Ù¸¥³»½Ã°æ¿¬±¸¼Ò ÀÌÁØÇà. EndoTODAY Endoscopy Learning Center. Lee Jun Haeng.