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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- 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.
- AN INNOVATIVE EX-VIVO MODEL FOR RAPID CHANGE OF THE PAPILLA FOR TEACHING ADVANCED ENDOSCOPIC RETROGRADE CHOLANGIOPANCREATOGRAPHY PROCEDURES(2016) ARTIFON, Everson L.A.; NAKADOMARI, Thaisa S.; KASHIWAGUI, Leandro Y.; BELMONTE, Emilio A.; SOLAK, Cláudio R.; CHENG, Spencer; FURUYA JR, Carlos K.; OTOCH, Jose P.ABSTRACT Background: Models for endoscopic retrograde cholangiopancreatography training allow practice with an expert feedback and without risks. A method to rapidly exchange the papilla can be time saving and accelerate the learning curve. Aim: To demonstrate a newly method of rapid exchange papilla in ex-vivo models to teach retrograde cholangiopancreatography advanced procedures. Methods: A new model of ex-vivo papilla was developed in order to resemble live conditions of procedures as cannulation, papilotomy or fistula-papilotomy, papiloplasty, biliary dilatation, plastic and metallic stentings. Results: The ex-vivo model of papilla rapid exchange is feasible and imitates with realism conditions of retrograde cholangiopancreatography procedures. Conclusion: This model allows an innovative method of advanced endoscopic training.
article 8 Citação(ões) na Scopus Surgical or endoscopic management for post-ERCP large transmural duodenal perforations: a randomized prospective trial(2015) ARTIFON, Everson L. A; K. MINATA, Mauricio; B. CUNHA, Marco Antonio; P. OTOCH, Jose; P. APARICIO, Dayse; K. FURUYA, Carlos; B. PAIONE, José L.Introduction: Duodenal perforations are an uncommon adverse event during ERCP. Patients can develop significant morbidity and mortality. Even though surgery has been used to manage duodenal complications, therapeutic endoscopy has seen significant advances. Objective: To compare endoscopic approach with surgical intervention in patients with duodenal perforations post-ERCP. Material and Methods: prospective randomized study in a tertiary center with 23 patients divided in 2 groups. Within 12 hours after the event, the patients underwent endoscopic or surgical approach. Endoscopic approach included closure of the perforation with endoclips and SEMS. Surgical repair included hepaticojejunostomy, suture of the perforation or duodenal suture. The success was defined as closure of the defect. Secondary outcomes included mortality, adverse events, days of hospitalization and costs. Results: The success was 100% in both groups. There was one death in the endoscopic group secondary to sepsis. There was no statistical difference in mortality or adverse events. We noticed statistical difference in favor of the endoscopic group considering shorter hospitalization (4.1 days versus 15.2 days, with p=0.0123) and lower cost per patient (U$14,700 versus U$19,872, with p=0.0103). Conclusions: Endoscopic approach with SEMS and endoclips is an alternative to surgery in large transmural duodenal perforations post-ERCP