Etzkorn K P, Diab F, Brown R D, Dodda G, Edelstein B, Bedford R, Venu R P
Therapeutic Endoscopy Services, University of Illinois at Chicago, 60612-7323, USA.
Gastrointest Endosc. 1998 May;47(5):363-7. doi: 10.1016/s0016-5107(98)70219-6.
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.
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.
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.
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.
内镜逆行胰胆管造影术（ERCP）期间通常采用清醒镇静。对于无法进行清醒镇静而需要全身麻醉的患者，ERCP的适应证和结局知之甚少。我们回顾性评估了2年间在4家教学医院接受ERCP且需要全身麻醉的患者的适应证和结局。
在2年期间进行的1200例ERCP中，65例患者需要全身麻醉。通过回顾性病历分析来确定全身麻醉下ERCP的适应证和结局。11例患者接受了Oddi括约肌测压。
全身麻醉的主要适应证是药物滥用。48例患者中有45例治疗干预成功；63例患者中有6例出现并发症，均为轻度且与麻醉无关。7例患者Oddi括约肌测压正常；4例患者基础压力升高。
当清醒镇静未能达到满意的镇静水平以成功安全地进行ERCP时，可考虑全身麻醉下的ERCP。与操作相关的并发症发生率即使不低于全身麻醉，似乎也相当。
