Abstract
Clear differences in the medical environment exist between core and local cities in Japan. In particular, there are marked differences in medical examination and treatment of pancreaticobiliary diseases. Therefore, we investigated whether the requirement for medical examination and treatment of pancreaticobiliary diseases is increasing and whether patient care can be improved by dispatching a pancreaticobiliary specialist to a hospital that does not have a pancreaticobiliary division. From August 2013 to March 2015, we retrospectively reviewed data of 68 patients (38 men, 30 women; median age 68 years) who underwent endoscopic ultrasonography (EUS) or transpapillary treatment at the Engaru Kosei General Hospital (Engaru Hospital) either by a visiting specialist from the pancreaticobiliary division of Asahikawa Kosei General Hospital (Asahikawa Hospital) or by doctors at Engaru Hospital. Of the 68 patients, 25 underwent EUS by the visiting specialist, and the accuracy rate based on observation and operative cases was 92.5% (23/25). Furthermore, 43 patients underwent transpapillary treatment by the visiting specialist, which was successful in 88.4% (38/43) of patients. However, the success rate of cases treated by doctors at Engaru Hospital was 75% (3/4). During this period, 14 patients from Engaru Hospital were sent to the Asahikawa Hospital: 2 had failed treatment by doctors at Engaru Hospital and the rest were patients who either preferred to be examined at Asahikawa Hospital or required more extensive examination. Therefore, dispatching pancreaticobiliary specialists to institutions without a pancreaticobiliary division is an effective means of distribution of medical resources. Furthermore, this reduces the patient<s burden of illness. We consider the concept of “hospital cooperation” to be an extremely useful system.
