2篇
您的检索式：作者名="Ko Tomishima"
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| 1 | Safety of immediate endoscopic sphincterotomy in acutesuppurative cholangitis caused by choledocholithiasis显示文摘AIM: To examine the safety of immediate endoscopic sphincterotomy(EST) in patients with acute suppurative cholangitis(ASC) caused by choledocholithiasis, as compared with elective EST.METHODS: Patients with ASC due to choledocholithiasis were allocated to two groups: Those who underwent EST immediately and those who underwent EBD followed by EST 1 wk later because they were under anticoagulant therapy, had a coagulopathy(international normalized ratio > 1.3, partial thromboplastin time greater than twice that of control), or had a platelet count < 50000 × 103/μL. One of four trainees [200-400 cases of endoscopic retrograde cholangiopancreatography(ERCP)] supervised by a specialist(> 10000 cases of ERCP) performed the procedures. The success and complication rates associated with EST in each group were examined.RESULTS: Of the 87 patients with ASC, 59 were in the immediate EST group and 28 in the elective EST group. EST was successful in all patients in both groups. There were no complications associated with EST in either group of patients, although white blood cell count, C-reactiveprotein, total bilirubin, and serum concentrations of liver enzymes just before EST were significantly higher in the immediate EST group than in the elective EST group.CONCLUSION: Immediate EST can be as safe as elective EST for patients with ASC associated with choledocholithiasis provided they are not under anticoagulant therapy, or do not have a coagulopathy or a platelet count < 50000 × 103/μL. Moreover, the procedure was safely performed by a trainee under the supervision of an experienced specialist. | Tomoyasu Ito Jin Kan Sai Hironao Okubo Hiroaki Saito Shigeto Ishii Ryo Kanazawa Ko Tomishima SumioWatanabe Shuichiro Shiina | 2016 | World Journal of Gastrointestinal Endoscopy2016，8，3： | 10 |
| 2 | Prior minimal endoscopic sphincterotomy to prevent pancreatitis related to endoscopic balloon sphincteroplasty显示文摘AIM To investigate the efficacy of prior minimal endoscopic sphincterotomy(EST) to prevent pancreatitis related to endoscopic balloon sphincteroplasty(EBS).METHODS After bile duct access was gained and cholangiogram confirmed the presence of stones < 8 mm in the common bile duct at endoscopic retrograde cholangiography, patients were subjected to minimal EST(up to one-third of the size the papilla) plus 8 mm EBS(ESTEBS group). The incidence of pancreatitis and the difference in serum amylase level after the procedure were examined and compared with those associated with 8-mm EBS alone in 32 patients of historical control(control group).RESULTS One hundred and five patients were included in the EST-EBS group, and complete stone removal was accomplished in all of them. The difference in serum amylase level after the procedure was- 25.0(217.9) IU/L in the EST-EBS group and this value was significantly lower than the 365.5(576.3) IU/L observed in the control group(P < 0.001). The incidence of post-procedure pancreatitis was 0%(0/105) in the EST-EBS group and 15.6%(5/32) in the control group(P < 0.001).CONCLUSION Prior minimal EST might be useful to prevent the elevation of serum amylase level and the occurrence of pancreatitis related to EBS. | Ryo Kanazawa Jin Kan Sai Tomoyasu Ito Hiroko Miura Shigeto Ishii Hiroaki Saito Ko Tomishima Ryo Shimizu Koki Sato Manabu Hayashi Sumio Watanabe Shuichiro Shiina | 2016 | World Journal of Gastrointestinal Endoscopy2016，8，18： | 0 |
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