ENDOSCOPIC RETROGRADE CHOLANGIOPANCREATOGRAPHY UNDER GENERAL-ANESTHESIA - INDICATIONS AND RESULTS

Background: Conscious sedation is usually used during endoscopic retro grade cholangiopancreatography (ERCP). Little is known about the indic ations 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 P-year period. Methods: Of 1200 ERCPs performed over a 2-year period, 65 pati ents required general anesthesia. Retrospective chart analysis was und ertaken to determine indications and outcomes of ERCP performed under general anesthesia. Eleven patients underwent sphincter of Oddi manome try. Results: The major indication for general anesthesia was substanc e abuse. Therapeutic intervention was successful in 45 of 48 patients; 6 of the 63 patients had complications, all mild and not related to t he anesthesia. Sphincter of Oddi manometry was normal in 7 patients; 4 patients had elevated basal pressures. Conclusions: ERCP under genera l anesthesia may be considered when conscious sedation fails to achiev e a satisfactory level of sedation for a successful and safe ERCP. pro cedure-related complication rates appear to be comparable if not lower with general anesthesia.