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Title: ブータン王国における内視鏡診療の経験
Other Titles: Experience of Endoscopy in the Kingdom of Bhutan
Authors: 二階堂, 光洋  KAKEN_name
宮本, 心一  KAKEN_name
児玉, 裕三  KAKEN_name
宇座, 徳光  KAKEN_name
辻, 喜久  KAKEN_name
角田, 茂  KAKEN_name
植村, 忠廣  KAKEN_name
岡島, 英明  KAKEN_name
前田, 紗江  KAKEN_name
高橋, 陽子  KAKEN_name
村本, 佳奈美  KAKEN_name
石井, 鮎子  KAKEN_name
西, 洋子  KAKEN_name
樋口, 浩和  KAKEN_name
武藤, 学  kyouindb  KAKEN_id
松原, 和夫  KAKEN_name
千葉, 勉  KAKEN_name
Author's alias: Nikaido, Mitsuhiro
Miyamoto, Shin'ichi
Kodama, Yuzo
Uza, Norimitsu
Tsuji, Yoshihisa
Tsunoda, Shigeru
Uemura, Tadahiro
Okajima, Hideaki
Maeda, Sae
Takahashi, Yoko
Muramoto, Kanami
Ishii, Ayuko
Nishi, Yoko
Higuchi, Hirokazu
Muto, Manabu
Matsubara, Kazuo
Chiba, Tsutomu
Keywords: ブータン
Issue Date: 28-Mar-2016
Publisher: 京都大学ヒマラヤ研究会; 京都大学ブータン友好プログラム; 京都大学霊長類学・ワイルドライフサイエンス・リーディング大学院
Journal title: ヒマラヤ学誌 : Himalayan Study Monographs
Volume: 17
Start page: 77
End page: 84
Abstract: 京都大学医学部附属病院の国際支援事業によりブータン王国にて内視鏡診療に従事する機会を得た。ブータンでは消化器内視鏡検査は国内唯一の消化器内科医師と外科医師により行われており, 治療困難な症例は国外へ搬送されていた。内視鏡的逆行性膵胆管造影 (Endoscopic Retrograde Chorangiopancreatography: ERCP) 目的の国外搬送も絶えないため, ERCP 導入を中心とした内視鏡診療支援を行うこととなった。10週間の滞在中に約900件の内視鏡を施行した。大部分は上部消化管内視鏡検査であったが, ERCP に関しても, 現地の医師, 看護師を指導しながら, 23件を施行した。ブータンの内視鏡診療の現況に加え, ブータン人における消化器疾患の頻度及び ERCP 導入の実際について報告する。
We provided medical care in the Kingdom of Bhutan from January to March in 2014 through the international medical support program of Kyoto University Hospital. Bhutan is a small, developing country with a population of about 700, 000 citizens located at the southern foot of the Himalayas. There are only 244 medical doctors in Bhutan (one-tenth of the number of doctors relative to population in Japan). Because of the shortage of doctors and the limited medical resources, patients with difficult-to-treat conditions are transferred to India or other countries. Gastrointestinal endoscopy is performed by the country's only gastroenterologist and six surgeons, mainly in Jigme Dorji Wangchuk National Referral Hospital (JDWNRH) at Thimphu. Several years before, a Bhutanese surgeon had learned to perform endoscopic retrograde cholangiopancreatography (ERCP) in Thailand. However, ERCP cannot be established in Bhutanese routine clinical practice because of its technical difficulty. Although a duodenoscope and some devices for ERCP are available, at least one patient who needs ERCP is transferred to India every month. In this context, I was asked to reintroduce ERCP into JDWNRH. ERCP was performed in 23 cases involving 17 patients with the cooperation of Bhutanese doctors, nurses, and technicians. My experience leads me to believe that we can build a platform to continue ERCP in JDWNRH. During the 10 weeks, I also helped to perform about 900 endoscopies, mainly esophagogastroduodenoscopy, and I taught endoscopic techniques and diagnostic approaches to Bhutanese doctors. In this report, I describe the current status of endoscopy in Bhutan including the incidence of Bhutanese gastrointestinal disorders and the experience specifically related to introducing ERCP.
Description: 特集1: 京都大学ブータン友好プログラム特集 = Special Issue 1: Contribution from the Kyoto Bhutan Friendship Program
DOI: 10.14989/HSM.17.77
Appears in Collections:第17号

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