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Biomedical subjects

C Sugawa

Publications and source records attributed to C Sugawa.

At least 55 records · Page 3Linked to original sources
PubMed1983

Endoscopic retrograde cholangiopancreatography after cholecystectomy.

One hundred and eighty-two patients with undiagnosed postcholecystectomy symptoms were studied by ERCP. Successful ampullary cannulation was achieved in 164 patients. ERCP findings revealed an abnormality in 120 patients (73 per cent). Endoscopic sphincterotomy and stone removal were successful in removing calculi in 13 of 17 patients in whom this procedure was attempted. ERCP is often the procedure of choice in the diagnosis and management of patients with postcholecystectomy symptoms. The information gained may permit definitive treatment of the causative conditions, including the extraction of biliary calculi after papillotomy in selected instances.

Abdomen↗
PubMed1983

Caroli's disease: role of endoscopic retrograde cholangiopancreatography.

Several modalities have been used in the diagnosis of congenital dilatation of the intrahepatic bile ducts (Caroli's disease) with varying degrees of reliability and morbidity. We report two patients with Caroli's disease where endoscopic retrograde cholangiopancreatography was used to define the anatomy of the extra and intrahepatic biliary trees. In one of the patients (BT) esophageal varices were easily visualized on endoscopy which had been previously demonstrated by a more invasive procedure (splenoportography). There were no complications of retrograde cholangiopancreatography in these two patients. We believe that retrograde cholangiopancreatography is a safe and effective method of evaluating the biliary tree and status of portal hypertension in patients with Caroli's disease as well as providing a reliable means of following the progression of their disease.

Adolescent↗
PubMed1982

A continuing appraisal of pancreatic ascites.

Pancreatic ascites is a distinct clinical entity characterized by elevated amylase and protein levels in the ascitic fluid. This should be distinguished from the ascites of cirrhosis, tuberculosis or metastatic carcinoma. Precise delineation of the ductal anatomy by endoscopic retrograde pancreatography preoperatively will enhance the ability of the surgeon to plan a rational operation and will, thereby, provide the best results. Medical treatment may obviate surgical intervention in a small number of instances but contains intrinsic hazards and should not be prolonged beyond three weeks. In carefully selected patients, limited pancreatic resection, encompassing the site of leakage, produces excellent results.

Adult↗
PubMed1982

The value of prophylactic antibiotic therapy during endoscopic retrograde cholangiopancreatography.

Prophylactic antibiotics have been recommended during endoscopic retrograde cholangiopancreatography in the hope of preventing septic complications. However, their effectiveness has not been proved clinically. In this study, the ability of the pancreas to secrete ampicillin, gentamicin and clindamycin after a single intravenous dosage, given prior to endoscopic retrograde cholangiopancreatography in 12 patients, was examined. Simultaneously obtained serum antibiotic levels were within the expected therapeutic range. In contrast, pancreatic ductal levels of ampicillin and gentamicin were too low to be measured in most patients. Most patients had measurable clindamycin levels which ranged from 12.0 to 3.1 micrograms per milliliter in seven patients and was 8.0 micrograms per milliliter in one patient. Parenteral prophylactic antibiotic coverage for endoscopic retrograde cholangiopancreatography is ineffective with gentamicin or ampicillin. Clindamycin may be of value, but it needs further study at higher dosages.

Adult↗
PubMed1979

Value of endoscopic retrograde pancreatography in pancreatic ascites.

Endoscopic retrograde pancreatography was easily performed preoperatively in six patients with pancreatic ascites, and no complications resulted from this procedure. The abnormalities observed during the procedure were unpredictable and varied. Endoscopic pancreatograms provided delineation of the pancreatic ductal system, showing one or more sites of ductal leaks into pseudocysts or segmental narrowing of the main pancreatic duct. This preoperative information was invaluable in selecting appropriate surgical procedures.

Adult↗
PubMed1979

Endoscopic retrograde pancreatography in the surgery of pancreatic pseudocysts.

Endoscopic retrograde pancreatography (ERP) was performed on 83 patients with 99 pancreatic pseudocysts (PCP). ERP was successful in 76 patients; in the other seven PCPs were found at operation. Five characteristic ductal patterns are described and illustrated. The PCPs were situated in the head (51 patients), body (21 patients), tail (20 patients). Thirteen PCPs were less than 2 cm, 50 were between 2 and 5 cm, 29 greater than 5 cm. There were multiple PCPs in 13.2% of patients. ERP was a more accurate diagnostic measure than ultrasonography or upper gastrointestinal roentgenograms, revealing the lesion in 89% of patients. Eight patients with pancreatic ascites had the causative PCP demonstrated prior to operation. Three patients had pancreatic pleural effusions; two with effusions on the right had PCPs of the tail. Five patients had spontaneous connections between a PCP and the stomach (four patients) or duodenum (one patient). Rational surgical planning for the management of PCPs is greatly facilitated by preliminary reconnaisance by ERP.

Adult↗
PubMed1977

Pancreatic pseudocysts communicating with the stomach: demonstration by endoscopic retrograde pancreatography.

The use of endoscopic retrograde pancreatography (ERP) provides important information in the management of pancreatic pseudocysts unavailable by other methods. When the pseudocysts communicate with a hollow viscus, the surgeon is better able to deal with the problem if aware of this fact prior to operative intervention. A pancreatic pseudocyst communicating with the stomach was demonstrated by ERP in each of four patients. One of these patients had pancreatic ascites and the other had left-sided pleural effusion, and both were treated successfully by distal pancreatectomy. The other two patients responded to nonoperative treatment. This report emphasizes the potential diagonstic value of ERP in determining the presence and the fate of pseudocysts.

Acute Disease↗
PubMed1976

Endoscopic complications. Results of the 1974 American Society for Gastrointestinal Endoscopy Survey.

Esophagogastroduodenoscopy (211,410 examinations) had a complication rate of 1.3/1,000 cases. Duodenoscopy with cannulation was performed 3,884 times and had a complication rate of 21.6/1,000 examinations. Diagnostic coloscopy (25,298 examinations) had a complication rate of 3.4/1,000. Polypectomies during coloscopy (6,124 cases) had a complication rate of 23.3/1,000 cases. Esophageal dilations (13,139 cases) had a complication rate of 4.25 with mercury bougies, and in 9,431 cases metal olives produced a complication rate of 6.1/1,000 treatments. Dilation for achalasia in 1,224 patients produced a complication rate of 18.4/1,000 procedures. Peritoneoscopy (4,404 examinations) produced a complication rate of 5.4/1,000 patients. The value of these diagnostic and therapeutic procedures is now well established but must be weighed against a potential risk of complications.

Endoscopes↗
PubMed1975

Electrocoagulation of bleeding in the upper part of the gastrointestinal tract: a preliminary experimental clinical report.

Electrocoagulation of gastric or esophageal bleeding sites was evaluated in dogs using a flexible suction coagulator electrode passed through the endoscope using an electrocautery unit (Cameron-Miller model 80-7910). Acute and chronic coagulation studies in 25 dogs showed that electrocoagulation of both the esophageal and gastric mucosa was safe at an electrocautery unit setting of 5 for three to five seconds. This level of coagulation was successful in stopping bleeding created from actively bleeding esophageal and gastric mucosal defects by taking multiple large biopsy specimens. Based on these data, six patients with active bleeding gastric lesions have undergone mucosal coagulation. This successfully stopped the bleeding initially in all six patients; two patients rebled and required operative intervention within 48 hours. Further clinical evaluation is being implemented to determine its clinical role in the treatment of bleeding in the upper part of the gastrointestinal tract.

Adult↗