Prevalence of Anesthetic and Gastrointestinal Complications of Endoscopic Retrograde Cholangiopancreatography

Abstract

Background: Endoscopic retrograde cholangiopancreatography (ERCP) is an endoscopic method for treatment of many biliary diseases. With respect to rapid recovery and more patient comfort, this procedure is currently performed under light general anesthesia (GA) or conscious sedation. Objectives: The current study aimed to clarify that intravenous sedation or light general anesthesia can be performed without great fear of anesthesia related complications in ERCP patients and sedative doses of propofol can be used safely in outpatient settings under the supervision of an expert anesthesiologist. Methods: This is a cross-sectional study on 1023 ERCP patients under light GA during 2014-2018 in Qom, Shahid Beheshti Hospital. Data were collected by a checklist and were analyzed by using chi-square test in SPSS V.22. Results: From 1023 patients, 501 (48.97 %) were male and 522 (51.03 %) were female with a mean age of 47.2 ± 6.7 years. The most common finding in ERCP was choledocholithiasis (76.15 %). The most common complication was hemodynamic instability (37.01 %) followed by desaturation (11.65 %) both of them ware anesthesia related. Prevalence of GI (gastrointestinal) related complications was 13.39 %. The most common GI related complications were pancreatitis (7.92 %) and bleeding (3.32 %). Total mortality rate was 0.88 %. Conclusions: ERCP-related complications are inevitable but can be controlled by early diagnosis and clinical experience. Severe complications and high risk patients may increase the mortality and morbidity of the procedure. Anesthesia related complications are more frequent than GI related unwanted events. Fortunately, the most common anesthesia related complications are readily manageable and are minor in nature when an expert anesthesiologist is present in the scene. Close monitoring of the patient's vital signs should be the mainstay of the safe procedure.

Adverse Outcomes of Endoscopic Retrograde Cholangiopancreatography at Gastroenterology and Hepatology Centers in Sulaymaniyah and Duhok City

“…Our study revealed that common findings of ERCP among studied patients were bile duct dilation (42.3%), filling defects (33.8%), and bile duct strictures (14.7%). These findings agree with the results of many works of literature, such as Hormati et al (21) cross-sectional study in Iran and Kröner et al (22) study in the USA, which reported common findings of ERCP were the findings of choledocholithiasis like bile duct dilation or strictures. In our study, the endoscopic sphincterotomy was done for (80.5%) of patients during ERCP, and the biliary or pancreatic duct stenting was done commonly by plastic stents (67%).…”

“…The present study showed that the mean age of patients who underwent ERCP was (53.1 years); 25% of them were in the age group 60-69 years, with a predominance of the female gender. These demographic characteristics are close to the results of Muslim et al (21) retrospective observational study on 545 patients who underwent ERCP in the Gastroenterology and Hepatology Center in Al-Diwaniyah city (Central Iraq) reported that a higher proportion of studied patients were in the age group 60-69 years with prevalent female gender (60.36%). In the current study, 85.5% of included patients were Kurdish, and 14.5% were Arabic.…”

Is endoscopist-directed sedation for endoscopic retrograde cholangiopancreatography with balanced propofol solution (BPS) practical and safe? A prospective study from a tertiary care centre in India

“…The outcomes of ERCP under EDNAS are similar to those done under anaesthetist-directed sedation with lower or similar complication rates [ 16 ]. Hence, our study proves that endoscopist-directed sedation does not affect the efficiency of the doctor.…”

Conversion from Deep Sedation to General Anesthesia in patients undergoing Endoscopic Retrograde Cholangiopancreatography: a series of cases

“…In view of the clinical characteristics of the patients, it is important to emphasize that an ERCP is an essential surgical procedure in the diagnosis and treatment of a variety of pancreaticbiliary disorders, for example, for the assessment of cholelithiasis cases until neoplasms [1], as well as repair biliary stenosis.…”