A comparative study between combined and separate EUS and ERCP under anesthesia for pancreati- cobiliary diseases

Abstract

Objective To explore the therapeutic value of endoscopic ultrasonography （EUS） com- bined with endoscopic retrograde cholangiopanereatography （ERCP） for the diagnosis and treatment of pan- ereaticobiliary diseases. Methods Clinical data were analysed retrospectively in patients who underwent both EUS and ERCP in a single anesthetic session （Group A） and separate procedure in two different ses- sions （ Group B）. The following variables of both groups were evaluated ： procedural time, propofol dose, ear- diopulmonary complications, endoscopic complications and diagnostic yield, and therapeutic procedures. Results Procedural time [GroupAvs. GroupB： （ 78. 56±15. 88 ） min vs. （97.78±34.56）mini andthe dose of propofol [ Group A vs. Group B ： （ 314. 21 ± 223.54 ） mg vs. （ 521.23 ± 245.12 ） mg ] differed signif- icantly between both groups （ P 〈 0. 05 ）. In Group A, the diagnostic rates of EUS and ERCP, cardiopulmo- nary complications rate and endoscopic complications rate were 91.4% （96/105）, 81.9% （86/105）, 6. 67% （7/105）, 3.81% （4/105） , respectively, and these variables of group B were 94. 4% （85/90）, 82.2% （74/90） , 5.56% （5/90） , 3.33% （3/90）. There were no significant differences in the diagnostic yield, cardiopulmonary complications and endoscopic complications between the two groups （ P 〉 0. 05 ）. Conclusion It is safe and feasible that EUS combined with ERCP is performed under anesthesia in a single session. It needs a significantly shorter procedural time and smaller dose of propofol compared with separate procedures for pancreaticobiliary diseases. Key words: Anesthesia; Cholangiopancreatography, endoscopic retrograde; Endoscopic uhraasonog- raphy; Pancreaticobiliary diseases