Buddhasothorn Hospital Journal

Nursing Care for Patients with Common Bile Duct Stones Undergoing Endoscopic Retrograde Cholangiopancreatography: A Case Study

Sirilux Tongsubanan — 2026-01-01

Common bile duct stone is a common public health problem in Thailand. Patients often present with symptoms similar to gastrointestinal disorders such as intestinal or gastric diseases, making diagnosis challenging. Gallstones usually form in the gallbladder, and if left untreated, they may migrate into the bile duct, causing distal obstruction. Endoscopic retrograde cholangiopancreatography (ERCP) is a procedure used for both diagnosis and treatment. It requires a relatively short duration, does not involve surgical incisions, but carries potential risks of complications. Therefore, nursing care plays a crucial role, requiring continuous and comprehensive assessment to ensure patient safety and support recovery to normal daily life.

Objective

To provide safe nursing care for patients with Common bile duct stone undergoing ERCP, preventing complications, and enabling patients to practice appropriate self-care both before and after the procedure as well as upon returning home.

Methods

This study employed a descriptive case study design involving one patient with Common bile duct stonetreated by ERCP between July 16–21, 2024, for a total of six days. Data were collected by the endoscopy unit nurse through medical history review and patient interviews. Nursing interventions were delivered across three stages: pre-procedure assessment and preparation, intra-procedure assistance during ERCP, and post-procedure follow-up. Telephone follow-ups were also conducted after hospital discharge. Patient and family education was provided regarding self-care at home and strategies to prevent recurrence of Common bile duct stone.

Results

The patient undergoing ERCP was safe, experienced no complications, and demonstrated the ability to perform self-care before and after the procedure, as well as at home following discharge. Subsequently, the patient underwent cholecystectomy to prevent recurrence of gallstones migrating into the bile duct.

Conclusion

Patients with Common bile duct stonewho undergo ERCP can achieve safe outcomes without complications and recurrence when provided with appropriate nursing care and education for effective self-management after discharge.

The factors influencing exercise behavior in overweight patients at anti-obesity clinic, Buddhasothorn hospital, Thailand

Kanlayanee Boonprasit — 2026-01-01

Background: Overweight and obesity are a significant public health problem with an increasing prevalence both nationally and in Chachoengsao province, impacting health and economy burdens. However, there is a lack of data about the factors that influence exercise behavior in Chachoengsao province.

Methods: This descriptive cross-sectional study was conducted at the anti-obesity clinic of Buddhasothorn Hospital. The target population is the patients with a Body Mass Index (BMI) more than 25 kg/m². Data were collected using a questionnaire covering demographic data, exercise behavior, and six domains of influencing factors. Data analysis was performed using descriptive statistics, Pearson's correlation and multiple regression analysis.

Results: The study included 96 participants. 82.29% of participants had poor exercise behavior. Self-efficacy was found a statistically significant positive correlation with exercise behavior (r = 0.3393, p < 0.05), whereas perceived barriers had a statistically significant negative correlation (r = -0.2448, p < 0.05). Multiple regression analysis revealed that self-efficacy was the only statistically significant predictor of exercise behavior (β = 0.1212, p = 0.035). Knowledge, attitude, perceived benefits and social support were not found a statistically significant factors.

Conclusion: Promoting exercise in overweight patients should focus on enhancing self-efficacy and decreasing perceived barriers, rather than providing knowledge alone for achieving effective and sustained behavioral change.

Keywords: Overweight, Obesity, Exercise Behavior, Influencing factors, Self-Efficacy

The effect of the motivation process to change behavior in diabetes risk group Nong Yao Subdistrict, Phanom Sarakham District, Chachoengsao Province

Natthida jitayanupap — 2026-01-01

Background and Significance: Diabetic ketoacidosis (DKA) is a common emergency in patients with diabetes and a major cause of hospitalization. Investigating risk factors within the context of a community hospital can provide insights into relevant determinants and contribute to the development of effective preventive measures.

Objective: To examine the association between personal, clinical, health behavior, and complication-related risk factors and the occurrence of DKA.

Methods: A retrospective analytical study was conducted among 176 patients with type 2 diabetes, comprising 44 patients with DKA and 132 without DKA. Data were collected from medical records between October 2022 and September 2024. Statistical analyses included descriptive statistics, chi-square test, t-test, and logistic regression.

Results: Significant risk factors for DKA included HbA1c ≥12% (OR = ∞, p<0.001), fasting blood glucose ≥400 mg/dL (OR = ∞, p<0.001), irregular medication use (OR = 10.82, p<0.001), concurrent infection (OR = 8.57, p<0.001), history of DKA (OR = 7.68, p<0.001), and insulin therapy (OR = 3.63, p=0.001).

Conclusion and Recommendations: Poor glycemic control and irregular medication use were key risk factors for DKA. Screening systems for high-risk patients and personalized preventive care programs should be developed to reduce DKA incidence effectively.

Clinical Characteristics, Risk factors and Outcomes of Patients with Acute Upper Gastrointestinal Bleeding in Sakaeo Crown Prince Hospital

Sittichoke Wattanarochanaporn — 2026-01-01

Background: Acute upper gastrointestinal bleeding (UGIB) is a common surgical emergency. Proper assessment of clinical characteristics is essential for planning management.

Objective: To investigate the clinical characteristics, risk factors, and outcomes of patients with acute UGIB.

Methods: A retrospective study was conducted on 170 patients with acute UGIB admitted to Sakaeo Crown Prince Hospital. Baseline characteristics, clinical presentations, laboratory results, endoscopic findings, treatments, and outcomes were analyzed and compared between variceal UGIB (VUGIB) and non-variceal UGIB (NVUGIB).

Results: The majority of patients were male (70.0%) with a mean age of 61.45 ± 14.20 years. Endoscopy revealed NVUGIB in 158 patients (92.9%) and VUGIB in 12 patients (7.1%). Among NVUGIB patients, peptic ulcer disease (PUD) was the most common cause (67.1%). The most common bleeding stigmata was a clean base (58.5%). Alcohol consumption was reported in 39.4% of all cases, and NSAID use was found in 24.7% of NVUGIB cases. Compared with NVUGIB, patients with VUGIB more often had liver cirrhosis (p < 0.001), ascites (p = 0.005), frequent hemodynamic instability (p = 0.032) and lower hemoglobin levels (p = 0.033). They also showed prolonged prothrombin time (p = 0.002), low albumin levels (p < 0.001), higher total bilirubin levels (p = 0.001), higher rates of endoscopic therapeutic interventions (p < 0.001), and greater blood transfusion requirements (p = 0.021). Overall, complications occurred in 5.9%, rebleeding in 5.3%, and mortality in 6.5%.

Conclusions: NVUGIB was the predominant cause of acute UGIB, and overall outcomes were favorable. Although less common, VUGIB required more endoscopic interventions and blood transfusions. Clinical and laboratory factors may guide early identification of VUGIB, which may lead to the development of a simple screening tool for community hospitals.

Result of Laparoscopic Surgery of Colorectal Cancer in Buddhasothorn Hospital

Chatchai Fonglertnukul — 2026-01-01

Background and Objective

Colorectal cancer ranks as the third most common malignancy globally and the fourth leading cause of cancer-related mortality. Laparoscopic surgery has emerged as a standard treatment modality for non-metastatic colorectal cancer, offering potential advantages over open surgery including reduced hospital stay, decreased wound infection rates, and faster recovery. Buddhasothorn Hospital initiated laparoscopic colorectal surgery in 2019. This study aimed to evaluate the outcomes of laparoscopic colorectal cancer surgery at our institution.

Methods

A retrospective study was conducted reviewing medical records of all patients who underwent laparoscopic colorectal cancer surgery at Buddhasothorn Hospital from January 1, 2019, to March 31, 2024. A total of 54 patients with non-metastatic colorectal cancer were included. Emergency surgery cases were excluded. Patient demographics, perioperative data, pathological results, and follow-up outcomes were analyzed.

Results

Of 54 patients, 26 were male and 28 were female with a mean age of 65.02 years old and mean BMI of 23.24 kg/m². The most common procedures were Laparoscopic low anterior resection (35.18%) and Laparoscopic sigmoidectomy/anterior resection (31.48%). Mean operative time was 4.22 hours, mean blood loss was 117.17 mL, and mean hospital stay was 10.57 days. Node retrieval was less than 12 node 18 case (33.33%)

Twenty-five percent of patients (n=14) received neoadjuvant concurrent chemoradiotherapy (CCRT), which significantly increased operative time (5.57 vs 3.75 hours, p<0.001), blood loss (159.29 vs 102.43 mL, p=0.014), and hospital stay (12.29 vs 9.98 days, p=0.016).

Overall complication rate was 5.56% (3 patients), including anastomotic leakage in 2 patients (3.7%) - one managed conservatively and one requiring reoperation. Conversion to open surgery occurred in 1 patient (1.85%) due to large tumor size (n=1).

Pathological staging revealed T3-T4 disease in 64.8% of patients. At follow-up (mean 2 years), no local recurrence was observed. Overall Distant metastasis occurred 16%

Conclusions

Laparoscopic colorectal cancer surgery at Buddhasothorn Hospital demonstrated acceptable outcomes with low complication (5.56%) and conversion rates (1.85%). No local recurrence was observed during the follow-up period. CCRT significantly increased operative complexity but remains an important treatment modality for locally advanced cases. These results are comparable to international standards, though operative times were longer than reported averages and node retrieval less than 12 node , likely due to case complexity and learning curve factors.