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D Tsujimura

Publications and source records attributed to D Tsujimura.

7 recordsLinked to original sources
PubMed1985

Endoscopic bipolar electrocoagulation in massive upper gastrointestinal bleeding.

We have reviewed 50 cases of upper gastrointestinal bleeding treated by endoscopic bipolar electrocoagulation (BPEC) and assessed its value in the management of massive bleeding. Initial hemostasis was achieved in 94% of cases with an overall rebleeding rate of 19.1%. The rebleeding rate was high among patients requiring blood transfusions more than 2,000 ml (47.3%) and those with acute gastric mucosal lesion (AGML) (35.3%). In AGML one or two primary sites of bleeding can be effectively controlled initially, but rebleeding tends to occur from other sites. Mortality from the direct effects of bleeding was also high in massive bleeders (33.3%) and those with AGML (22.2%); the overall mortality, including deaths from ongoing underlying diseases, was 38%. Although BPEC failed to alter the fatal outcome of patients with massive acute mucosal bleeding, permanent or temporary hemostasis contributed to reducing the amount of blood transfusions, avoiding emergency operation, preventing rapid deterioration and prolonging the survival time. Endoscopic BPEC has proven to be an effective emergency hemostatic method in massive bleeding of the upper gastrointestinal tract as an alternative to surgical intervention.

Adolescent↗
PubMed1984

Endoscopic bipolar electrocoagulation in upper gastrointestinal bleeding.

A new endoscopically deliverable bipolar electrocoagulator has been developed, and employed clinically to treat upper gastrointestinal bleeding in 53 patients on 61 occasions. By direct application of the electrode to the bleeding vessels immediate hemostasis was achieved in 52 out of 53 bleeding vessels. Non-bleeding visible vessels were safely coagulated. Arrest of bleeding was permanent in 44 patients (83%), of whom 20 were candidates for emergency operation because of massive, continued or recurrent bleeding. Rebleeding after hemostasis by bipolar electrocoagulation was noted in 8 patients (15%); however, the majority of rebleeds were those with acute mucosal lesions who had serious underlying medical problems. Emergency operation was performed in 5 patients, and was averted in most patients after successful hemostasis by bipolar electrocoagulation. There were no complications related to the procedure. Bipolar electrocoagulation with our coagulator is a safe and easily applicable technique that is a promising addition to currently available endoscopic hemostatic methods.

Adolescent↗
PubMed1982

Endoscopic bipolar electrocoagulation: development of a new bipolar coagulator for stopping gastrointestinal bleeding.

We have developed an endoscopically deliverable bipolar coagulator with a pair of active bipolar electrodes and tested its efficacy and safety in canine gastric bleeding models. Hemostasis was achieved with a few applications in all "ulcer maker", gastric serosal vessel, mesenteric vessel and endoscopic "hot biopsy" models. Histologically the mean muscular injury was 10.1% in ulcer maker models and 17.1% in hot biopsy models, significantly less than monopolar electrodes. No full thickness injury resulted. Initial clinical trials in 32 patients with upper gastrointestinal bleeding revealed 100% immediate hemostasis; it could stop spurting arterial bleeding. Our bipolar coagulator is a promising addition to the endoscopic hemostatic methods.

Adolescent↗