An international team of expert anesthesiologists and gastroenterologists, including Montefiore Einstein Department of Anesthesiology Chair Dr. Matthias Eikermann, have determined that patients undergoing endoscopic retrograde cholangiopancreatography (ERCP) may be better served by deep sedation without tracheal intubation, compared to receiving general anesthesia with tracheal intubation. The clinician scientists developed evidence-based practical guidelines, which were published in the British Journal of Anaesthesia, after assessing the merits and risks of both techniques for ERCP.

ERCP is a procedure that combines upper gastrointestinal endoscopy and x-rays to treat issues of the bile and pancreatic ducts. Each year 600,000 ERCP procedures are performed in the United States. The procedure is time-consuming, resource intensive and can lead to adverse events. After assessing a variety of complex patient scenarios, the group determined that for short routine procedures, with low complexity, monitored anesthesia care (deep sedation) rather than general anesthesia could lead to faster and better recovery after ERCP. The experts stress, however, that each institution should take the recommendation after evaluating their own resources, expertise, and individual patient characteristics.

Read the full publication in the British Journal of Anaesthesia.