Endoscopic retrograde cholangiopancreatography
|Lines and access||
Standard ASA monitors
|Primary anesthetic considerations|
Most patients should be considered for RSI
Endoscopic approach to access the bile duct utilized to diagnose and treat liver, gallbladder, biliary, and pancreatic problems. Endoscope is inserted from the mouth to duodenum. Then the papilla of vater (Common bile duct outlet) is identified, catheterized, and injected with contrast to identify obstructions.
liver, gallbladder, biliary, and pancreatic pathology
|Airway||ETT required, bite block|
|Other||Check cervical ROM|
Labs and studies
Operating room setup
- Make sure you have a lead apron available
- Have a prone pillow available and staff to help turn
- Have bite block to facilitate scope passage available.
Patient preparation and premedication
Regional and neuraxial techniques
Monitoring and access
- Standard ASA monitors
Induction and airway management
- Most patients will be prone for this procedure to aid in manipulation of scope into proper placement. If patient cannot tolerate position, lateral or supine positioning can be done (increases difficulty for proceduralist).
Maintenance and surgical considerations
General anesthesia with ETT. TIVA or volatile
- If obstruction in bile duct is removed, there is a high risk of bile aspiration. Have suction readily available.
|Variant 1||Variant 2|