| 特集名 | 高齢者における消化器疾患 -- 低侵襲治療を中心に | |
|---|---|---|
| 題名 | 高齢者に対するERCP | |
| 発刊年月 | 2007年 12月 | |
| 著者 | 角谷 宏 | 東京慈恵会医科大学内視鏡科 |
| 著者 | 荒川 廣志 | 東京慈恵会医科大学内視鏡科 |
| 著者 | 内山 勇二郎 | 東京慈恵会医科大学内視鏡科 |
| 著者 | 池田 圭一 | 東京慈恵会医科大学内視鏡科 |
| 著者 | 田尻 久雄 | 東京慈恵会医科大学消化器・肝臓内科 |
| 著者 | 岡本 友好 | 東京慈恵会医科大学外科 |
| 【 要旨 】 | まず，高齢者の内視鏡施行時の呼吸循環動態について述べた．高齢者は予備能が低下しており起きうる変化を熟知し，少しの変化を見逃さないように早めの対策をとることが重要である．適度な鎮静剤の使用は呼吸循環動態に対して若年者も含めて良い作用をもたらす． ERCP (endoscopic retrograde cholangio-pancreatography) に関しては手技の種類，対象疾患や偶発症の多彩さなど習得しなければならないことが多く，多くの症例を施行している施設が偶発症対策には有利である．一たび偶発症が起きた場合は十分な全身状態の管理とその対策が要求される． 本邦においては諸外国に比べ医療裁判制度が十分機能しているとは言い難く，この点にも留意する必要がある． |
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| Theme | Gastrointestinal Disease in the Elderly Focusing on Minimally Invasive Therapy | |
|---|---|---|
| Title | ERCP in the Elderly | |
| Author | Hiroshi Kakutani | Department of Endoscopy, The Jikei University School of Medicine |
| Author | Hiroshi Arakawa | Department of Endoscopy, The Jikei University School of Medicine |
| Author | Yujiro Uchiyama | Department of Endoscopy, The Jikei University School of Medicine |
| Author | Keiichi Ikeda | Department of Endoscopy, The Jikei University School of Medicine |
| Author | Hisao Tajiri | Department of Gastroenterology and Hepatology, The Jikei University School of Medicine |
| Author | Tomoyoshi Okamoto | Department of Surgery, The Jikei University School of Medicine |
| [ Summary ] | The respiratory and circulatory dynamics of elderly people during endoscopic procedures are described. It is important to take early measures not to overlook slight changes that could occur during endoscopic procedures due to low physical capacity. Moderate usage of sedative procedures good results for the respiratory and circulatory dynamics of elderly patients as well as younger. In regard to ERCP, many issues concerning target diseases or diversity of complications must be mastered. For that reason, high volume facilities employing ERCP related procedures have some advantages in taking measures to deal with complications. Once complications during or after ERCP have occurred, intensive management of the general state of patients should be taken as early as possible. In Japan, unlike European countries or United States, it must be said that medical judicature does not function adequately at this time. When the measures for complications are discussed, this point should also be considered. |
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