トクシマ シミン ビョウイン ダイキボ ビョウイン ニオケル ソシキテキ Safety Management

Numerous medical errors have been reported on mass media recently. It is a regret that people have become less confident in medicine and have a great deal of skepticism in medical service. Medical profession is now committing to do everything possible to remove their skepticism and restore the confidence in medicine. However, increasing complexity in medical technologies and diversified medical services have made it difficult to eradicate medical errors completely. Nevertheless, we must do everything possible to reduce medical mistakes to an acceptable level. This can be only achieved by the all-out effort of the entire hospital staffs, not by the vigilance of the individual doctor, nurse or technician. We have to face a challenge to improve patient safety and build safer system by the joint effort of all the members of the hospital staffs. We have just initiated the systematic safety programs for the patients, though there are still many problems remaining to be solved. We documented and discussed our concept of informed consent at Tokushima Municipal Hospital, how it is practiced in our daily medical service

ゴウリュウブ ケッセキ Confluence Stone ノ 1チケンレイ

Confluence stone is a rare disease that is difficult to diagnose before surgery and thattend to accompany intraoperative biliary tract injury and postoperative stenosis, unexpectively.We have report a case of confluence stone.The patient was 67-year-old woman. During treatment for cholecystolithiasis at anotherhospital, she had upper abdominal pain three times without fever up and jaundice. Shewas reffered to our hospital for a detailed examination. Ultrasonography, CT and endoscopicretrograde cholangiopancreatography (ERCP) allowed a diagnosis of common bileduct stenosis caused by confluence stone. Laparotomy was then performed. No malignancywas shown despite of seveve cholecystitis. Thus cholecystectomy was carried out,then the biliary stenosis was repaired by patch graft method.It is known that confluence stone arise biliostasis with the progression of chroniccholecystitis. Therefore, in cases of severe chronic cholecystitis we should consider thepossibility of the confluence stone and take care of the biliary tract injury and postoperativestenosis