PPPD 케이스 스터디

소개

췌장암수술 PPPD 케이스 스터디 레포트 입니다

목차

V. 간호과정
1) 환자의 기왕력 및 검사결과
2) 간호과정

본문내용

(3) 과거력
- 5년전 hemorroidectomy

(4) 가족력
아버지 : 간질환
오빠 : 간암

(5) 입원동기
- 2011.5.14 abdomen pain, fever 있어 타병원에서 시행한 검사상 CBD stricture 소견으로 ERCP, ERBD insertion 시행함. biopsy상 distal CBD, adenocarcinoma 진단받고 수술위해 pf.장진영 외래 통해 입원함.

(6) 진단검사 (입원전)
① CT abdomen dynamic +3D(biliarypancreas (contrast) (2011.7.27.)
ERBD state for malignant biliary obstruction.
less likely biliary obstruction.
multifiocal patchy periductal enhancement -> r/o ascending cholangitis,
r/o pancreatic cancer at uncinate process, with retropancreatic fat infiltration
② Chest PA
- no active lung lesion
③ EKG
- normal sinus rhythm
④ PFT
- normal ventilatory function

<중 략>

(11) 외과병리학적 검사보고
DIAGNOSIS:
Pancreas, common bile duct and duodenum,
pylorous preserving pancreaticoduodenectomy:
ADENOCARCINOMA, moderately differentiated
- Gross type: nodular
- Location of tumor: head
- Size of tumor: 3.2 x 2.2 x 1.5cm
- Depth of invasion: Tumor extends beyond the pancreas, bile duct,
duodenum, peripancreatic soft tissue and ampulla of Vater (pT3)
- Bile duct invasion: invasion of mucosa
- Duodenal invasion: invasion of muscularis propria
- Surgical margins: free from tumor
Safety margin: common bile duct, 3.5cm; pancreatic resection margin, 2.2cm;
pancreatic radial margin, 0.1cm; proximal duodenal margin, 1.5cm;
distal duodenal margin, 21.5cm
- Lymph node: present
metastasis in six out of 24 lymph nodes (pN1)
(peritumoral LN, 4/10; peripancreatic LN, 1/4;
"LN": 1/9; LN#16 (Fro #1), 0/1)

참고자료

· 없음