Abstract:
BACKGROUND AND STUDY AIMS:In adults, general anesthesia is usually only provided during endoscopic retrograde cholangiopancreatography (ERCP) when prior attempts using conscious sedation have failed. It was hypothesized that in our hospital, other factors might be associated with general anesthesia for ERCP. The aim of this study was therefore to assess the indications for ERCP under general anesthesia, and to evaluate the underlying diseases, type, and efficacy of ERCP under general anesthesia in comparison with conscious sedation. PATIENTS AND METHODS:We retrospectively analyzed 1,056 ERCPs that had been carried out with the patients under general anesthesia or conscious sedation. The indications for general anesthesia were recorded, and the underlying diseases, the type and success of the interventions, and the causes of premature ERCP termination in both groups were assessed. RESULTS:Eighteen percent of the ERCPs were performed under general anesthesia and 82% under conscious sedation. The indications for general anesthesia were related to the type of procedure planned (46%), premature termination of ERCP under conscious sedation (28%), and other reasons. Patients with primary sclerosing cholangitis and liver transplant recipients received general anesthesia more frequently (general anesthesia vs. conscious sedation, 36% vs. 16%, P < 0.0001 and 22% vs. 13%, P = 0.003). Conscious sedation was provided more frequently in patients with neoplasms and cholelithiasis (21% vs. 12%, P = 0.004 and 13% vs. 3%, P < 0.001). Painful dilations were performed more frequently with the patients under general anesthesia (60% vs. 19%, P < 0.001), whereas major papillotomies were preferably performed with conscious sedation (34% vs. 21%, P = 0.006). More interventions per ERCP were performed with the patient under general anesthesia compared to conscious sedation (P < 0.001), during the same time (51 +/- 28 min vs. 52 +/- 26 min, P = 0.39). With conscious sedation, the ERCP failure rate was double that with general anesthesia (7% vs. 14%, P = 0.012), mainly due to inadequate conscious sedation (61%). CONCLUSIONS:The frequent use of general anesthesia for ERCP at our institution is related to the underlying diseases, which are frequently treated with complex and painful ERCP procedures. The efficacy of ERCP with general anesthesia supports a continued preference for general anesthesia rather than conscious sedation when complex and painful interventional ERCP procedures are planned.
journal_name
Endoscopyjournal_title
Endoscopyauthors
Raymondos K,Panning B,Bachem I,Manns MP,Piepenbrock S,Meier PNdoi
10.1055/s-2002-33567subject
Has Abstractpub_date
2002-09-01 00:00:00pages
721-6issue
9eissn
0013-726Xissn
1438-8812journal_volume
34pub_type
杂志文章相关文献
ENDOSCOPY文献大全abstract::A conceptual difference between "analog" and "digital" digitizing is reviewed. Analog and digital type image filing systems are discussed from a comparative point of view: The analog type is advantageous in the number of recordable images, the recording and reproducing speed, and the ability to record a moving picture...
journal_title:Endoscopy
pub_type: 杂志文章
doi:10.1055/s-2007-1010531
更新日期:1992-07-01 00:00:00
abstract::The introduction of videoendoscopy has had a revolutionary impact on endoscopy teaching on a small scale within the Endoscopy unit itself and on a larger scale in the Conference Room which may be local or distant. The teaching of anatomy, pathology and endoscopic techniques have all been significantly affected and fur...
journal_title:Endoscopy
pub_type: 杂志文章
doi:10.1055/s-2007-1012882
更新日期:1990-09-01 00:00:00
abstract::Peroral cholangioscopy is useful in differentiating benign from malignant biliary strictures. However, when conventional biliary access via endoscopic retrograde cholangiopancreatography (ERCP) fails, percutaneous transhepatic cholangioscopy (PTCS) via the SpyGlass cholangioscopy system can be used to achieve a diagno...
journal_title:Endoscopy
pub_type: 杂志文章
doi:10.1055/s-0034-1392527
更新日期:2015-11-01 00:00:00
abstract::Ulcerative colitis is characterized as an inflammatory process of the distal colonic mucosa, which may extend proximally. Its proximal extension is classically as a continuous lesion. We describe six patients presenting with typical ulcerative proctiits, who were also found to have an inflammatory area in the caecum, ...
journal_title:Endoscopy
pub_type: 杂志文章
doi:10.1055/s-2002-33239
更新日期:2002-08-01 00:00:00
abstract:BACKGROUND AND STUDY AIMS:Compared with any other location in the gastrointestinal tract, the duodenum presents the most challenging site for endoscopic resection. The aim of this study was to analyze the clinical outcomes of duodenal endoscopic resection and to assess the feasibility of the technique as a therapeutic ...
journal_title:Endoscopy
pub_type: 杂志文章
doi:10.1055/s-0034-1390774
更新日期:2015-02-01 00:00:00
abstract::Early diagnosis, endoscopic differentiation of benign from malignant lesions, and removal of clinically significant tumors are increasingly considered to be major topics of interest in the upper gastrointestinal tract. This interest is mainly due to the development of better imaging tools and new resection techniques ...
journal_title:Endoscopy
pub_type: 杂志文章,评审
doi:10.1055/s-0031-1291427
更新日期:2011-11-01 00:00:00
abstract::Biliary manometry, the "gold standard" for the diagnosis of sphincter of Oddi dysfunction, is associated with technical and methodological problems. The lack of a suitable experimental model has hindered efforts to solve these problems. We report here on the first practical animal model for endoscopic biliary manometr...
journal_title:Endoscopy
pub_type: 杂志文章
doi:10.1055/s-2007-1005636
更新日期:1995-01-01 00:00:00
abstract::This report describes a complication that occurred as a result of deploying an Ultraflex stent too low in relation to a stenosing carcinoma of the gastro-oesophageal junction. Intermittent kinking of the redundant lower end of the stent caused frequent episodes of total dysphagia. A percutaneous endoscopic gastrostomy...
journal_title:Endoscopy
pub_type: 杂志文章
doi:10.1055/s-2007-1001294
更新日期:1998-05-01 00:00:00
abstract::The results obtained using endoscopic sphincterotomy (EST) in the management of postoperative biliary complications of hepatic hydatid disease are presented. The outcome was favourable in all eight patients treated with no associated morbidity or mortality. In three patients the clinical manifestations of cholangitis ...
journal_title:Endoscopy
pub_type: 杂志文章
doi:10.1055/s-2007-1010687
更新日期:1991-09-01 00:00:00
abstract:BACKGROUND AND STUDY AIM:A prototype forward-viewing instrument has been developed for therapeutic endoscopic ultrasound (EUS)-guided fine needle aspiration (FNA). We had the opportunity to use this forward-viewing echo endoscope and to study its clinical usefulness, mainly for diagnostic EUS-FNA. PATIENTS AND METHODS...
journal_title:Endoscopy
pub_type: 杂志文章
doi:10.1055/s-0030-1256508
更新日期:2011-09-01 00:00:00
abstract:BACKGROUND AND STUDY AIMS:The effectiveness of the prophylactic clip for the prevention of postpolypectomy bleeding in pedunculated colonic polyps has not been confirmed. The aim of this prospective, randomized study was to compare the efficacy of prophylactic clip and endoloop application in the prevention of postpoly...
journal_title:Endoscopy
pub_type: 杂志文章,多中心研究,随机对照试验
doi:10.1055/s-0034-1365515
更新日期:2014-07-01 00:00:00
abstract:BACKGROUND AND STUDY AIMS:Both endoscopic ultrasound- (EUS-) guided tissue sampling techniques, fine-needle aspiration (FNA) and Trucut biopsy, have advantages and limitations. The aim of this study was to develop a strategy of combining these two EUS-guided sampling techniques in order to maximize the diagnostic accur...
journal_title:Endoscopy
pub_type: 杂志文章,多中心研究
doi:10.1055/s-2007-966400
更新日期:2007-08-01 00:00:00
abstract::BACKGROUND AND STUDY AIMS : Current colonoscopy practice requires removal of diminutive polyps. This is associated with costs, but the benefits to colorectal cancer (CRC) prevention remain unclear. The study aim was to understand patients' willingness to defer resection of diminutive polyps and to examine the factors ...
journal_title:Endoscopy
pub_type: 杂志文章,多中心研究
doi:10.1055/s-0043-121221
更新日期:2018-03-01 00:00:00
abstract:BACKGROUND AND STUDY AIMS:Endoscopic surveillance for Barrett's esophagus (BE) is limited by long procedure times and sampling error. Near-infrared (NIR) fluorescence imaging minimizes tissue autofluorescence and optical scattering. We assessed the feasibility of a topically applied NIR dye-labeled lectin for the detec...
journal_title:Endoscopy
pub_type: 杂志文章
doi:10.1055/s-0043-124080
更新日期:2018-06-01 00:00:00
abstract::Background Participants' experience with a screening test can influence adherence, and therefore the efficacy of screening programs. We compared screening with unsedated flexible sigmoidoscopy and fecal immunochemical testing (FIT) for participants' satisfaction with the decision and for willingness to repeat colorect...
journal_title:Endoscopy
pub_type: 杂志文章,随机对照试验
doi:10.1055/s-0043-117400
更新日期:2017-11-01 00:00:00
abstract::PillCam colon capsule endoscopy (CCE) is an innovative noninvasive, and painless ingestible capsule technique that allows exploration of the colon without the need for sedation and gas insufflation. Although it is already available in European and other countries, the clinical indications for CCE as well as the report...
journal_title:Endoscopy
pub_type: 杂志文章,实务指引
doi:10.1055/s-0031-1291717
更新日期:2012-05-01 00:00:00
abstract:UNLABELLED:SPECIFIC AUTHOR CONTRIBUTIONS: Andreas Vécsei, MD, and Ulrike Graf wrote the manuscript. All authors contributed to study design, data collection and analysis, and approved the final draft for submission. The corresponding author declares that the manuscript is submitted on behalf of all authors. BACKGROUND...
journal_title:Endoscopy
pub_type: 杂志文章
doi:10.1055/s-0028-1103484
更新日期:2009-02-01 00:00:00
abstract:BACKGROUND AND STUDY AIMS:Severe bleeding is a potentially lethal complication after endoscopic sphincterotomy (EST) and endoscopic papillary balloon dilation (EPBD) for choledocholithiasis. This study aimed to evaluate the impact of antiplatelet agents and anticoagulants on this complication. PATIENTS AND METHODS:Pat...
journal_title:Endoscopy
pub_type: 杂志文章
doi:10.1055/s-0034-1392408
更新日期:2015-11-01 00:00:00
abstract:BACKGROUND AND STUDY AIMS:Many studies have reported on laterally spreading tumors (LSTs), but systematic reviews of the data to determine their risk of containing submucosal invasion (SMI) are lacking. We systematically screened and analyzed the available literature to provide a more solid basis for evidence-based tre...
journal_title:Endoscopy
pub_type: 杂志文章,meta分析
doi:10.1055/s-0043-121144
更新日期:2018-03-01 00:00:00
abstract::To protect the assistants from radiation during ERCP, a remote contrast injector employing a lever mechanism (push lever type) was developed. Using this remote injector, safe, finely controlled and easy injection of the contrast material was achieved without X-ray exposure to the assistants in ERCP. ...
journal_title:Endoscopy
pub_type: 杂志文章
doi:10.1055/s-2007-1021616
更新日期:1982-09-01 00:00:00
abstract::In view of increasingly accurate noninvasive diagnostic imaging modalities for pancreatic diseases, endoscopic retrograde cholangiopancreatography (ERCP) should be mainly restricted to therapeutic indications. Acute pancreatitis is still the most common complication of ERCP. Prevention measures should focus in particu...
journal_title:Endoscopy
pub_type: 杂志文章,评审
doi:10.1055/s-2004-814119
更新日期:2004-01-01 00:00:00
abstract::The extent of, and age-related changes in, the acid-secreting area in patients with duodenal ulcer were compared with those in patients with gastric ulcer and healthy subjects. Studies were made by the endoscopic Congo red test developed in our clinic. The incidence of a large acid-secreting area was significantly hig...
journal_title:Endoscopy
pub_type: 杂志文章
doi:10.1055/s-2007-1021523
更新日期:1983-07-01 00:00:00
abstract:BACKGROUND AND STUDY AIMS:It has been recommended that patients with angina, a normal coronary angiogram, and no other signs of heart disease, should be evaluated using esophagogastroduodenoscopy before referral to dynamic esophageal investigations. The aim of the present study was to investigate the clinical value of ...
journal_title:Endoscopy
pub_type: 杂志文章
doi:10.1055/s-2007-1005715
更新日期:1995-06-01 00:00:00
abstract::"Golytely", a lavage solution for colonoscopic preparation, has been in clinical use since 1980. Patients usually drink all the fluid (4-61 "Golytely") the morning before colonoscopy. However, clinical observation shows that many, especially elderly, patients have difficulty tolerating these large volumes. We therefor...
journal_title:Endoscopy
pub_type: 杂志文章
doi:10.1055/s-2007-1018281
更新日期:1987-09-01 00:00:00
abstract:BACKGROUND AND STUDY AIMS:Although discrete ulcers are a recognized complication of Barrett's esophagus, it is not clear how common discrete ulceration is in Barrett's mucosa. Furthermore, the relationship of gastrointestinal hemorrhage to Barrett's ulceration is unknown. These issues were investigated in this paper. ...
journal_title:Endoscopy
pub_type: 杂志文章
doi:10.1055/s-2007-1001284
更新日期:1998-05-01 00:00:00
abstract:BACKGROUND AND AIMS:Fully covered self-expanding removable stents (SERS) have been considered a viable alternative to serial bougienage. The primary aim of this meta-analysis was to determine the efficacy of SERS for refractory esophageal strictures. METHODS:Medline, Embase, and PubMed databases were searched using th...
journal_title:Endoscopy
pub_type: 杂志文章,meta分析
doi:10.1055/s-0030-1256331
更新日期:2011-05-01 00:00:00
abstract:BACKGROUND AND STUDY AIMS:In endoscopic nasobiliary drainage (ENBD), repositioning the catheter from the mouth to the nose is complicated. We devised a method using catheters with magnets and verified its utility and safety. PATIENTS AND METHODS:We prospectively enrolled 20 patients undergoing ENBD at Yokohama City Un...
journal_title:Endoscopy
pub_type: 临床试验,杂志文章
doi:10.1055/s-0033-1344330
更新日期:2013-10-01 00:00:00
abstract::Following peptic ulcer hemorrhage, the ability to accurately determine those patients at highest risk of rebleeding relies on clinical and endoscopic criteria which are accurate in only a variable proportion of cases. In this study we have assessed prediction of rebleeding in peptic ulcers using a transendoscopic vasc...
journal_title:Endoscopy
pub_type: 杂志文章
doi:10.1055/s-2007-1012795
更新日期:1990-03-01 00:00:00
abstract::A plea is made for individual age-adjusted endoscopic therapy of precancerous lesions and, under certain conditions, of early gastric carcinoma. True adenoma and borderline lesion have to be resected, if technically feasible, by snare ectomy. Tumour remnants or local recurrences can be destroyed by argon laser applica...
journal_title:Endoscopy
pub_type: 杂志文章
doi:10.1055/s-2007-1021723
更新日期:1980-05-01 00:00:00
abstract:BACKGROUND AND STUDY AIMS:The endoscopic treatment of symptomatic pharyngoesophageal diverticula (PED) with rigid instruments involves the incision of the septum between the diverticulum and the esophageal lumen, within which the cricopharyngeal muscle is present. The aim of this study is to report on the feasibility a...
journal_title:Endoscopy
pub_type: 杂志文章
doi:10.1055/s-2007-1005736
更新日期:1995-08-01 00:00:00