Endoscopic Retrograde Cholangiopancreatography Under General Anesthesia Compared to Conscious Sedation Study.

Autor:	Greaves G; Orthopedic Surgery, University of Alberta Hospital, Edmonton, AB, Canada., Harding KG; General Surgery, Memorial University of Newfoundland, St John's, NL, Canada., Parker B; Provincial Health Services Authority, Kelowna, BC, Canada., Nguyen VC; Faculty of Medicine, University of British Columbia, Vancouver, BC, Canada., Ahmed A; Faculty of Medicine, University of British Columbia, Vancouver, BC, Canada., Yee B; Internal Medicine, University of Saskatoon, Saskatoon, SK, Canada., Perren J; Pediatrics, Memorial University of Newfoundland, St John's, NL, Canada., Norman M; Faculty of Medicine, University of British Columbia, Vancouver, BC, Canada., Grey M; Kelowna Gastroenterology Associates, Kelowna, BC, Canada., Perini R; Kelowna Gastroenterology Associates, Kelowna, BC, Canada.; Gastroenterology, Kelowna General Hospital, Kelowna, BC, Canada.; University of British Columbia Okanagan, Southern Medical Program, Kelowna, BC, Canada., Jowhari F; Kelowna Gastroenterology Associates, Kelowna, BC, Canada.; Gastroenterology, Kelowna General Hospital, Kelowna, BC, Canada.; University of British Columbia Okanagan, Southern Medical Program, Kelowna, BC, Canada., Bak A; Kelowna Gastroenterology Associates, Kelowna, BC, Canada.; Gastroenterology, Kelowna General Hospital, Kelowna, BC, Canada.; University of British Columbia Okanagan, Southern Medical Program, Kelowna, BC, Canada.
Jazyk:	angličtina
Zdroj:	Journal of the Canadian Association of Gastroenterology [J Can Assoc Gastroenterol] 2023 Oct 03; Vol. 7 (2), pp. 154-159. Date of Electronic Publication: 2023 Oct 03 (Print Publication: 2024).
DOI:	10.1093/jcag/gwad037
Abstrakt:	Background: Endoscopic retrograde cholangiopancreatography (ERCP) is used to diagnose and treat pancreatic and biliary disease. The current standard is to conduct ERCP under conscious sedation (CS). Patient movement and agitation during ERCP under CS can result in procedure failure and complications. Aiming to reduce procedure failure rates and complications, Kelowna General Hospital (KGH) in British Columbia, Canada transitioned to performing ERCP under general anesthesia (GA) as the practice standard. Objective: To determine if conducting ERCP under GA compared to CS decreases procedure complications, particularly post-ERCP pancreatitis (PEP). Methods: The charts of 2,198 patients who underwent ERCP at KGH between 2015 and 2020 were reviewed. Before September 17, 2017, ERCP was performed under CS ( n = 1,316). Afterwards, ERCP was conducted under GA ( n = 882). Demographic, clinical, and procedural data were extracted. The data were analyzed using univariate and multivariate statistical analysis. Results: Procedure failure rates (CS = 9 percent, GA = 3 percent, P < 0.001) decreased in the GA cohort after adjusting for age, sex, and co-morbidities. Thirty-day mortality, intensive care unit (ICU) transfer, returns post-discharge, PEP, and cholangitis rates were similar between cohorts. Conclusion: Performing ERCP under GA compared to CS resulted in an increase in procedural success rates. Other complication rates were similar between groups. Competing Interests: There are no conflicts of interest. (© The Author(s) 2023. Published by Oxford University Press on behalf of the Canadian Association of Gastroenterology.)
Databáze:	MEDLINE
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