CARLOS KIYOSHI FURUYA JUNIOR
Projetos de Pesquisa
Unidades Organizacionais
Instituto do Coração, Hospital das Clínicas, Faculdade de Medicina - Médico
LIM/26 - Laboratório de Pesquisa em Cirurgia Experimental, Hospital das Clínicas, Faculdade de Medicina
LIM/26 - Laboratório de Pesquisa em Cirurgia Experimental, Hospital das Clínicas, Faculdade de Medicina
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conferenceObject Endoscopic Papillary Large Balloon Dilation Associated With Sphincterotomy for Extraction of Large Bile Duct Stones(2012) LUZ, Gustavo O.; MOURA, Eduardo G. De; MEINE, Gilmara C.; CARNEIRO, Fred O.; MEDRADO, Bruno F.; ALMEIDA, Maira R.; MALUF-FILHO, Fauze; LERA, Marcos; IDE, Edson; FURUYA, Carlos K.; CHAVES, Dalton M.; CHENG, Spencer; MATUGUMA, Sergio E.; TOMISHIGE, Toshiro; HONDO, Fabio Y.; BARACAT, Renato; ARTIFON, Everson L.; FRANZINI, Tomazo; SAKAI, PauloCommon bile duct stones larger than 15mm are related to a higher rate of failure of endoscopic ductal clearance and need for mechanical lithotripsy. Recently, endoscopic papillary large balloon dilation (EPLBD) associated with endoscopic sphyncterotomy (ES) has been advocated for the management of difficult bile duct stones. Objective: Evaluate the efficacy and safety of EPLBD associated with ES for removal of large bile duct stones. Patients and methods: retrospective review of prospectively collected data in an academic tertiary referral center, from November 2009 to August 2011. Ampullary dilation was performed with a wire guided hydrostatic balloon (CRE/Boston Scientific) which size ranged from 12 to 20mm. The stone size and the duct diameter directed the choice of the balloon diameter. Balloon was inflated with diluted contrast medium under endoscopic and fluoroscopic control until waist disappearance and/or maximal balloon pressure. After dilation stones were extracted with the aid of standard accessories and techniques. Outcomes and adverse events were recorded. Results: A total of 730 patients with common bile duct stones were admitted for ERCP in our institution. 123 (16,8%) patients were submitted to EPLBD after sphincterotomy. The mean age was 56 years (22-98) and 77 were female (63%). The size of the stones ranged from 13 to 30mm. Initial procedure success rate without mechanical lithitripsy was 83% (102/123). In further 4 patients (3,2%) mechanical lithotripsy was used with 75% success rate (3/4). For the remaining 17 patients, mechanical litotripsy was not available and a 10Fr biliary stent was introduced to prevent obstruction and cholangitis. The total adverse events rate was 3,2%. There were 2 cases of perforation with 20mm balloon (1,6%), both treated conservatively, and two cases of mild acute pancreatitis (1,6%). None of the patients presented bleeding that required transfusion or hospitalization. Conclusion: EPLBD after sphincterotomy is a safe and effective technique for the management of large bile duct stones and it avoids mechanical lithotripsy in the majority of cases.- Papillary fistulotomy vs conventional cannulation for endoscopic biliary access: A prospective randomized trial(2018) FURUYA, Carlos Kiyoshi; SAKAI, Paulo; MARINHO, Fabio Ramalho Tavares; OTOCH, Jose Pinhata; CHENG, Spencer; PRUDENCIO, Livia Lemes; MOURA, Eduardo Guimaraes Hourneaux de; ARTIFON, Everson Luiz de AlmeidaAIM To compare the cannulation success, biochemical profile, and complications of the papillary fistulotomy technique vs catheter and guidewire standard access. METHODS From July 2010 to May 2017, patients were prospectively randomized into two groups: Cannulation with a catheter and guidewire (Group.) and papillary fistulotomy (Group.). Amylase, lipase and C-reactive protein at T0, as well as 12 h and 24 h after endoscopic retrograde cholangiopancreatography, and complications (pancreatitis, bleeding, perforation) were recorded. RESULTS We included 102 patients (66 females and 36 males, mean age 59.11 +/- 18.7 years). Group. and Group. had 51 patients each. The successful cannulation rates were 76.5% and 100%, respectively (P = 0.0002). Twelve patients (23.5%) in Group. had a difficult cannulation and underwent fistulotomy, which led to successful secondary biliary access (Failure Group). The complication rate was 13.7% (2 perforations and 5 mild pancreatitis) vs 2.0% (1 patient with perforation and pancreatitis) in Groups. and., respectively (P = 0.0597). CONCLUSION Papillary fistulotomy was more effective than guidewire cannulation, and it was associated with a lower profile of amylase and lipase. Complications were similar in both groups.
bookPart Dilatação transpapilar e de estenoses benignas das vias biliares(2014) ARTIFON, Everson Luiz de Almeida; SAKAI, Paulo; JúNIOR, Carlos Kiyoshi Furuya; LUZ, Gustavo OliveiraconferenceObject CONVENTIONAL CANNULATION OR PAPILLARY FISTULOTOMY: A PROSPECTIVE RANDOMIZED TRIAL(2018) FURUYA, Carlos K.; MARINHO, Fabio R.; CHENG, Spencer; SAKAI, Paulo; ARTIFON, Everson L.- Biliary stenosis extreme endoscopy treatment-very large balloon dilation: a new concept(2015) MOURA, Eduardo G. H. de; FURUYA JR., Carlos K.; MESTIERI, Luiz H. M.; MEDRADO, Bruno F.; CARNEIRO, Fred O.; ARTIFON, Everson L.; HERMAN, Paulo; SAKAI, Paulo
conferenceObject NEAR FOCUS HIGH-DEFINITION ENDOSCOPY FOR THE DETECTION OF GASTRIC INFECTION BY HELICOBACTER PYLORI(2021) FIUZA, Felipe; MALUF-FILHO, Fauze; MARTINS, Bruno; ARAUJO, Gabriela A.; STABACH, Luciana; RUAS, Jennifer N.; IDE, Edson; FURUYA, Carlos K.; FYLYK, Sonia N.; MATUGUMA, Sergio E.; UEMURA, Ricardo S.; YAMAZAKI, Kendi; SAKAI, Christiano M.; SAKAI, Paulo; UEDA, Sergio S.bookPart Papilotomia endoscópica: opções técnicas no cateterismo difícil(2014) ARTIFON, Everson Luiz de Almeida; UEMURA, Ricardo Sato; JúNIOR, Carlos Kiyoshi Furuya; CHENG, Spencer; SAKAI, Paulo