Endoscopic retrograde cholangiopancreatography under general anesthesia: indications and results.
BACKGROUND
Conscious sedation is usually used during endoscopic retrograde cholangiopancreatography (ERCP). Little is known about the indications and outcomes for ERCP in patients who cannot undergo conscious sedation and therefore require general anesthesia. We retrospectively evaluated the indications and outcome for patients undergoing ERCP who required general anesthesia at four teaching hospitals over a 2-year period.


METHODS
Of 1200 ERCPs performed over a 2-year period, 65 patients required general anesthesia. Retrospective chart analysis was undertaken to determine indications and outcomes of ERCP performed under general anesthesia. Eleven patients underwent sphincter of Oddi manometry.


RESULTS
The major indication for general anesthesia was substance abuse. Therapeutic intervention was successful in 45 of 48 patients; 6 of the 63 patients had complications, all mild and not related to the anesthesia. Sphincter of Oddi manometry was normal in 7 patients; 4 patients had elevated basal pressures.


CONCLUSIONS
ERCP under general anesthesia may be considered when conscious sedation fails to achieve a satisfactory level of sedation for a successful and safe ERCP. Procedure-related complication rates appear to be comparable if not lower with general anesthesia.
Etzkorn
K P
KP
Therapeutic Endoscopy Services, University of Illinois at Chicago, 60612-7323, USA.
Diab
F
F
Brown
R D
RD
Dodda
G
G
Edelstein
B
B
Bedford
R
R
Venu
R P
RP
D000293:Adolescent; D000328:Adult; D000368:Aged; D000768:Anesthesia, General; D001649:Bile Duct Diseases / Q000175:diagnosis*; D002648:Child; D002675:Child, Preschool; D002760:Cholangiopancreatography, Endoscopic Retrograde / Q000379:methods*; D003937:Diagnosis, Differential; D005069:Evaluation Studies as Topic; D005260:Female; D006801:Humans; D008297:Male; D008875:Middle Aged; D010182:Pancreatic Diseases / Q000175:diagnosis*; D012189:Retrospective Studies; D012680:Sensitivity and Specificity