The Experts below are selected from a list of 243 Experts worldwide ranked by ideXlab platform

Chung-huang Kuo - One of the best experts on this subject based on the ideXlab platform.

  • A comparison between non-sedation and general Endotracheal Anesthesia for retrograde endoscopic common bile duct stone removal: A tertiary center experience.
    Biomedical journal, 2019
    Co-Authors: Chih-ming Liang, Chung-mou Kuo, Cheng-en Tsai, Ming-te Kuo, Yi-chun Chiu, Wen-chen Tai, Yuan-hung Kuo, Chung-huang Kuo
    Abstract:

    BACKGROUND Conscious sedation is not routinely administered for therapeutic endoscopic retrograde cholangiopancreatography (ERCP) in many countries. The aim of our retrospective study was to compare the safety and rate of success and complications during common bile duct (CBD) stone extraction using ERCPs performed with no-sedation (NS) or under general Endotracheal Anesthesia (GET). METHODS The medical records of all patients who underwent ERCP for biliary stone extraction between January 2010 and September 2013 were reviewed, and patients classified to the NS and GET groups. The primary outcomes were the rate of success of complete stone removal and rate of complications, including post-ERCP pancreatitis (PEP), perforation, bleeding, pneumonia, and mortality within 30 days post-ERCP. Operative time was recorded for analysis. RESULTS During the study period, 630 patients underwent ERCP, 402 with NS and 105 with GET. Among the 402 patients in the NS group, 37 (9.2%) could not complete the procedure due to an inability to tolerate the procedure. The success rate of complete stone extraction was higher among patients in the GET group than the NS group (94.3% versus 75.6%, respectively; p 

  • a comparison between non sedation and general Endotracheal Anesthesia for retrograde endoscopic common bile duct stone removal a tertiary center experience
    Biomedical journal, 2019
    Co-Authors: Chih-ming Liang, Chung-mou Kuo, Cheng-en Tsai, Ming-te Kuo, Yi-chun Chiu, Wen-chen Tai, Yuan-hung Kuo, Chung-huang Kuo, Sengkee Chuah, Chisin Changchien
    Abstract:

    BACKGROUND Conscious sedation is not routinely administered for therapeutic endoscopic retrograde cholangiopancreatography (ERCP) in many countries. The aim of our retrospective study was to compare the safety and rate of success and complications during common bile duct (CBD) stone extraction using ERCPs performed with no-sedation (NS) or under general Endotracheal Anesthesia (GET). METHODS The medical records of all patients who underwent ERCP for biliary stone extraction between January 2010 and September 2013 were reviewed, and patients classified to the NS and GET groups. The primary outcomes were the rate of success of complete stone removal and rate of complications, including post-ERCP pancreatitis (PEP), perforation, bleeding, pneumonia, and mortality within 30 days post-ERCP. Operative time was recorded for analysis. RESULTS During the study period, 630 patients underwent ERCP, 402 with NS and 105 with GET. Among the 402 patients in the NS group, 37 (9.2%) could not complete the procedure due to an inability to tolerate the procedure. The success rate of complete stone extraction was higher among patients in the GET group than the NS group (94.3% versus 75.6%, respectively; p < 0.001). The rate of contrast injection into the pancreatic duct was higher for the NS than GET group (24.9% versus 15.2%, respectively; p = 0.008). Although non-significant, there was a higher incidence of post-ERCP pancreatitis (PEP) in the NS than in the GET group (10.4% versus 5.7%, respectively; p = 0.105), while the incidence of pneumonia was higher for the GET group. Biliary pancreatitis, contrast injection into the pancreatic duct and an operation time ≥30 min were independent risks factors for PEP. CONCLUSIONS ERCP under GET is effective for CBD stone removal, but with slightly higher pneumonia rate after the procedure than non-sedated ERCP.

Chih-ming Liang - One of the best experts on this subject based on the ideXlab platform.

  • A comparison between non-sedation and general Endotracheal Anesthesia for retrograde endoscopic common bile duct stone removal: A tertiary center experience.
    Biomedical journal, 2019
    Co-Authors: Chih-ming Liang, Chung-mou Kuo, Cheng-en Tsai, Ming-te Kuo, Yi-chun Chiu, Wen-chen Tai, Yuan-hung Kuo, Chung-huang Kuo
    Abstract:

    BACKGROUND Conscious sedation is not routinely administered for therapeutic endoscopic retrograde cholangiopancreatography (ERCP) in many countries. The aim of our retrospective study was to compare the safety and rate of success and complications during common bile duct (CBD) stone extraction using ERCPs performed with no-sedation (NS) or under general Endotracheal Anesthesia (GET). METHODS The medical records of all patients who underwent ERCP for biliary stone extraction between January 2010 and September 2013 were reviewed, and patients classified to the NS and GET groups. The primary outcomes were the rate of success of complete stone removal and rate of complications, including post-ERCP pancreatitis (PEP), perforation, bleeding, pneumonia, and mortality within 30 days post-ERCP. Operative time was recorded for analysis. RESULTS During the study period, 630 patients underwent ERCP, 402 with NS and 105 with GET. Among the 402 patients in the NS group, 37 (9.2%) could not complete the procedure due to an inability to tolerate the procedure. The success rate of complete stone extraction was higher among patients in the GET group than the NS group (94.3% versus 75.6%, respectively; p 

  • a comparison between non sedation and general Endotracheal Anesthesia for retrograde endoscopic common bile duct stone removal a tertiary center experience
    Biomedical journal, 2019
    Co-Authors: Chih-ming Liang, Chung-mou Kuo, Cheng-en Tsai, Ming-te Kuo, Yi-chun Chiu, Wen-chen Tai, Yuan-hung Kuo, Chung-huang Kuo, Sengkee Chuah, Chisin Changchien
    Abstract:

    BACKGROUND Conscious sedation is not routinely administered for therapeutic endoscopic retrograde cholangiopancreatography (ERCP) in many countries. The aim of our retrospective study was to compare the safety and rate of success and complications during common bile duct (CBD) stone extraction using ERCPs performed with no-sedation (NS) or under general Endotracheal Anesthesia (GET). METHODS The medical records of all patients who underwent ERCP for biliary stone extraction between January 2010 and September 2013 were reviewed, and patients classified to the NS and GET groups. The primary outcomes were the rate of success of complete stone removal and rate of complications, including post-ERCP pancreatitis (PEP), perforation, bleeding, pneumonia, and mortality within 30 days post-ERCP. Operative time was recorded for analysis. RESULTS During the study period, 630 patients underwent ERCP, 402 with NS and 105 with GET. Among the 402 patients in the NS group, 37 (9.2%) could not complete the procedure due to an inability to tolerate the procedure. The success rate of complete stone extraction was higher among patients in the GET group than the NS group (94.3% versus 75.6%, respectively; p < 0.001). The rate of contrast injection into the pancreatic duct was higher for the NS than GET group (24.9% versus 15.2%, respectively; p = 0.008). Although non-significant, there was a higher incidence of post-ERCP pancreatitis (PEP) in the NS than in the GET group (10.4% versus 5.7%, respectively; p = 0.105), while the incidence of pneumonia was higher for the GET group. Biliary pancreatitis, contrast injection into the pancreatic duct and an operation time ≥30 min were independent risks factors for PEP. CONCLUSIONS ERCP under GET is effective for CBD stone removal, but with slightly higher pneumonia rate after the procedure than non-sedated ERCP.

Vladimir M. Kushnir - One of the best experts on this subject based on the ideXlab platform.

  • Anesthesia-administered sedation for endoscopic retrograde cholangiopancreatography: monitored Anesthesia care or general Endotracheal Anesthesia?
    Current Opinion in Anesthesiology, 2019
    Co-Authors: Zachary L. Smith, Vladimir M. Kushnir
    Abstract:

    Purpose of reviewThe decision to undertake monitored Anesthesia care (MAC) or general Endotracheal Anesthesia (GEA) for patients undergoing endoscopic retrograde cholangiopancreatography (ERCP) is influenced by many factors. These include locoregional practice preferences, procedure complexity, pati

  • a randomized controlled trial evaluating general Endotracheal Anesthesia versus monitored Anesthesia care and the incidence of sedation related adverse events during ercp in high risk patients
    Gastrointestinal Endoscopy, 2019
    Co-Authors: Zachary L. Smith, Daniel Mullady, Gabriel Lang, Robert M Hovis, Riddhi S Patel, Thomas Hollander, Jeffery Elsner, Catherine Ifune, Vladimir M. Kushnir
    Abstract:

    Abstract Background and Aims ERCP is a complex procedure and often performed in patients at high risk for sedation-related adverse events (SRAE). However, there is no current standard of care with regard to mode of sedation and airway management during ERCP. The aim of this study was to assess the safety of general Endotracheal Anesthesia (GEA) versus propofol-based monitored Anesthesia care without Endotracheal intubation (MAC) in patients undergoing ERCP at high risk for SRAE. Methods Consecutive patients undergoing ERCP at high risk for SRAE at a single center were invited to participate in this randomized-controlled trial (NCT02850887) comparing GEA and MAC. Inclusion criteria were: STOP-BANG score of ≥3, abdominal ascites, body mass index (BMI) ≥35, chronic lung disease, ASA class >3, Mallampati class 4 airway, moderate to heavy alcohol use. Exclusion criteria were preceding EUS, emergent ERCP, tracheostomy, unstable airway, gastric outlet obstruction or delayed gastric emptying, and altered foregut anatomy. The primary endpoint was composite incidence of SRAE: (hypoxemia, use of airway maneuvers, hypotension requiring vasopressors, sedation-related procedure interruption, cardiac arrhythmia, and respiratory failure. Secondary outcomes included procedure duration, cannulation success, in-room time and immediate adverse events. Results Two hundred patients (mean age 61.1±13.6 years, 36.5% female) were randomly assigned to GEA (n=101) or MAC (n=99). Composite SRAE were significantly higher in the MAC group compared with GEA (51.5% vs 9.9%, p Conclusion In patients at high risk for SRAE undergoing ERCP, sedation with GEA is associated with a significantly lower incidence of SRAE, without impacting procedure duration, success, recovery, or in-room time. These data suggest that GEA should be used for ERCP in patients at high risk for sedation-related adverse events; www.clinicaltrials.gov , (NCT02850887).

Chisin Changchien - One of the best experts on this subject based on the ideXlab platform.

  • a comparison between non sedation and general Endotracheal Anesthesia for retrograde endoscopic common bile duct stone removal a tertiary center experience
    Biomedical journal, 2019
    Co-Authors: Chih-ming Liang, Chung-mou Kuo, Cheng-en Tsai, Ming-te Kuo, Yi-chun Chiu, Wen-chen Tai, Yuan-hung Kuo, Chung-huang Kuo, Sengkee Chuah, Chisin Changchien
    Abstract:

    BACKGROUND Conscious sedation is not routinely administered for therapeutic endoscopic retrograde cholangiopancreatography (ERCP) in many countries. The aim of our retrospective study was to compare the safety and rate of success and complications during common bile duct (CBD) stone extraction using ERCPs performed with no-sedation (NS) or under general Endotracheal Anesthesia (GET). METHODS The medical records of all patients who underwent ERCP for biliary stone extraction between January 2010 and September 2013 were reviewed, and patients classified to the NS and GET groups. The primary outcomes were the rate of success of complete stone removal and rate of complications, including post-ERCP pancreatitis (PEP), perforation, bleeding, pneumonia, and mortality within 30 days post-ERCP. Operative time was recorded for analysis. RESULTS During the study period, 630 patients underwent ERCP, 402 with NS and 105 with GET. Among the 402 patients in the NS group, 37 (9.2%) could not complete the procedure due to an inability to tolerate the procedure. The success rate of complete stone extraction was higher among patients in the GET group than the NS group (94.3% versus 75.6%, respectively; p < 0.001). The rate of contrast injection into the pancreatic duct was higher for the NS than GET group (24.9% versus 15.2%, respectively; p = 0.008). Although non-significant, there was a higher incidence of post-ERCP pancreatitis (PEP) in the NS than in the GET group (10.4% versus 5.7%, respectively; p = 0.105), while the incidence of pneumonia was higher for the GET group. Biliary pancreatitis, contrast injection into the pancreatic duct and an operation time ≥30 min were independent risks factors for PEP. CONCLUSIONS ERCP under GET is effective for CBD stone removal, but with slightly higher pneumonia rate after the procedure than non-sedated ERCP.

Yi-chun Chiu - One of the best experts on this subject based on the ideXlab platform.

  • A comparison between non-sedation and general Endotracheal Anesthesia for retrograde endoscopic common bile duct stone removal: A tertiary center experience.
    Biomedical journal, 2019
    Co-Authors: Chih-ming Liang, Chung-mou Kuo, Cheng-en Tsai, Ming-te Kuo, Yi-chun Chiu, Wen-chen Tai, Yuan-hung Kuo, Chung-huang Kuo
    Abstract:

    BACKGROUND Conscious sedation is not routinely administered for therapeutic endoscopic retrograde cholangiopancreatography (ERCP) in many countries. The aim of our retrospective study was to compare the safety and rate of success and complications during common bile duct (CBD) stone extraction using ERCPs performed with no-sedation (NS) or under general Endotracheal Anesthesia (GET). METHODS The medical records of all patients who underwent ERCP for biliary stone extraction between January 2010 and September 2013 were reviewed, and patients classified to the NS and GET groups. The primary outcomes were the rate of success of complete stone removal and rate of complications, including post-ERCP pancreatitis (PEP), perforation, bleeding, pneumonia, and mortality within 30 days post-ERCP. Operative time was recorded for analysis. RESULTS During the study period, 630 patients underwent ERCP, 402 with NS and 105 with GET. Among the 402 patients in the NS group, 37 (9.2%) could not complete the procedure due to an inability to tolerate the procedure. The success rate of complete stone extraction was higher among patients in the GET group than the NS group (94.3% versus 75.6%, respectively; p 

  • a comparison between non sedation and general Endotracheal Anesthesia for retrograde endoscopic common bile duct stone removal a tertiary center experience
    Biomedical journal, 2019
    Co-Authors: Chih-ming Liang, Chung-mou Kuo, Cheng-en Tsai, Ming-te Kuo, Yi-chun Chiu, Wen-chen Tai, Yuan-hung Kuo, Chung-huang Kuo, Sengkee Chuah, Chisin Changchien
    Abstract:

    BACKGROUND Conscious sedation is not routinely administered for therapeutic endoscopic retrograde cholangiopancreatography (ERCP) in many countries. The aim of our retrospective study was to compare the safety and rate of success and complications during common bile duct (CBD) stone extraction using ERCPs performed with no-sedation (NS) or under general Endotracheal Anesthesia (GET). METHODS The medical records of all patients who underwent ERCP for biliary stone extraction between January 2010 and September 2013 were reviewed, and patients classified to the NS and GET groups. The primary outcomes were the rate of success of complete stone removal and rate of complications, including post-ERCP pancreatitis (PEP), perforation, bleeding, pneumonia, and mortality within 30 days post-ERCP. Operative time was recorded for analysis. RESULTS During the study period, 630 patients underwent ERCP, 402 with NS and 105 with GET. Among the 402 patients in the NS group, 37 (9.2%) could not complete the procedure due to an inability to tolerate the procedure. The success rate of complete stone extraction was higher among patients in the GET group than the NS group (94.3% versus 75.6%, respectively; p < 0.001). The rate of contrast injection into the pancreatic duct was higher for the NS than GET group (24.9% versus 15.2%, respectively; p = 0.008). Although non-significant, there was a higher incidence of post-ERCP pancreatitis (PEP) in the NS than in the GET group (10.4% versus 5.7%, respectively; p = 0.105), while the incidence of pneumonia was higher for the GET group. Biliary pancreatitis, contrast injection into the pancreatic duct and an operation time ≥30 min were independent risks factors for PEP. CONCLUSIONS ERCP under GET is effective for CBD stone removal, but with slightly higher pneumonia rate after the procedure than non-sedated ERCP.