Biliary drainage by endoscopic choledochoduodenal fistulotomy in patients with papillary carcinoma.

Background: There are few reports of endoscopic choledochoduodenal fistulotomy (endoscopic fistulotomy) in patients with papillary carcinoma by using a needle-knife.

Methods: Among 35 patients with papillary carcinoma requiring biliary drainage, 14 with a suprapapillary bulge underwent endoscopic fistulotomy alone or with widening of the fistula by using a standard sphincterotome or dilation balloon catheter.

Observations: Transfistula bile duct cannulation was successful on the first attempt in 13 of 14 patients (93%) and temporary biliary drainage through the fistula was successfully established in all 13 patients.

An individualized teaching program for atherosclerotic risk factor reduction in patients with myocardial infarction.

This study was conducted to evaluate the effect of a teaching program on patients with myocardial infarction. Forty-five patients were randomly selected 22 were assigned to a teaching group and 23 to a control group. An individualized teaching program was delivered to the teaching group during the hospitalization period.