ERCP Sedation in a Tertiary Center: Anesthesia Management and Analysis of Factors Affecting Length of Hospital Stay in 341 Cases

Öz

Background: This study aimed to investigate anesthesia management, peri-procedural complication profiles, and risk factors affecting hospital length of stay in patients undergoing Endoscopic retrograde cholangiopancreatography (ERCP) under sedation.
Materials and Methods: A total of 341 patients who underwent ERCP at our tertiary care hospital were retrospectively analyzed to address the study's objectives. The patients’ demographic characteristics, comorbidities, doses of anesthetic agents used (midazolam, propofol, fentanyl), peri-procedural complications, and length of hospital stay were recorded. Data were analyzed using comparisons by age groups (<65 and ≥65 years), Spearman’s correlation, and multiple linear regression analysis to identify predictors of length of hospital stay.
Results: The findings demonstrated that comorbidities were present in 62.5% of patients, and the overall complication rate was 8.2%. Although anesthetic drug consumption was significantly lower in patients aged 65 and older (p<0.01), complication rates were found to be higher. Regression analysis revealed that the development of perioperative complications, the need for intensive care, and a reduction in fentanyl dosage were factors independently prolonging the length of hospital stay (p<0.05). Conclusions: Monitored anesthesia care used in ERCP procedures is safe in patients with high comorbidity. However, despite dose reduction, the increased risk of complications in geriatric patients warrants close monitoring. Our study further revealed that the primary factors prolonging hospital stay are perioperative complications, the need for intensive care, and low fentanyl dosing. Therefore, effective analgesia management-conducted in accordance with ERAS principles and led by an anesthesiologist-remains the most critical determinant of accelerating discharge.

Anahtar Kelimeler

• Endoscopic retrograde cholangiopancreatography
• Monitored anesthesia care
• Deep sedation
• Postoperative complications
• Length of stay

Etik Beyan

Ethical approval for this study was obtained from the by Harran University Faculty of Medicine Clinical Research Ethics Committee (approval no: HRÜ/25.17.35, date: October 13, 2025).

Üçüncü Basamak Bir Merkezde ERCP Sedasyonu: 341 Vakada Anestezi Yönetimi ve Hastanede Kalış Süresini Etkileyen Faktörlerin Analizi

Öz

Amaç: Bu çalışmanın amacı, sedasyon altında Endoskopik Retrograd Kolanjiyopankreatografi (ERCP) uygulanan hastalarda anestezi yönetimini, işlem sırasındaki komplikasyon profillerini ve hastanede kalış süresini etkileyen risk faktörlerini araştırmaktı. Materyal ve metod: Çalışmanın amaçlarını gerçekleştirmek üzere, üçüncü basamak hastanemizde ERCP uygulanan toplam 341 hasta retrospektif olarak analiz edildi. Hastaların demografik özellikleri, eşlik eden hastalıkları, kullanılan anestezik ajanların dozları (midazolam, propofol, fentanil), işlem sırasındaki komplikasyonlar ve hastanede kalış süresi kaydedildi. Veriler, hastanede kalış süresinin belirleyicilerini tespit etmek amacıyla yaş gruplarına göre (<65 ve ≥65 yaş) karşılaştırmalar, Spearman korelasyonu ve çoklu doğrusal regresyon analizi kullanılarak analiz edildi.
Bulgular: Hastaların %62,5’inde komorbiditelerin mevcut olduğunu ve genel komplikasyon oranının %8,2 olduğunu gösterdi. 65 yaş ve üstü hastalarda anestezik ilaç tüketimi anlamlı olarak daha düşük olmasına rağmen (p<0,01), komplikasyon oranlarının daha yüksek olduğu saptandı. Regresyon analizi, perioperatif komplikasyonların gelişmesi, yoğun bakım ihtiyacı ve fentanil dozunda azalmanın, hastanede kalış süresini bağımsız olarak uzatan faktörler olduğunu ortaya koydu (p<0,05). Sonuç: ERCP prosedürlerinde kullanılan Monitörize Anestezi Bakımı, yüksek komorbiditeye sahip hastalarda güvenlidir. Ancak, doz azaltımına rağmen, geriatrik hastalarda komplikasyon riskinin artması, yakın izlemeyi gerektirmektedir. Çalışmamız ayrıca, hastanede kalış süresini uzatan başlıca faktörlerin perioperatif komplikasyonlar, yoğun bakım ihtiyacı ve düşük fentanil dozu olduğunu ortaya koymuştur. Bu nedenle, ERAS ilkelerine uygun olarak ve bir anestezi uzmanı tarafından yürütülen etkili analjezi yönetimi, taburculuğu hızlandırmanın en kritik belirleyicisi olmaya devam etmektedir.

Anahtar Kelimeler

• Endoskopik retrograd kolanjiyopankreatografi
• Monitörize anestezi bakımı
• Derin sedasyon
• Ameliyat sonrası komplikasyonlar
• Hastanede kalış süresi

Etik Beyan

Ethical approval for this study was obtained from the by Harran University Faculty of Medicine Clinical Research Ethics Committee (approval no: HRÜ/25.17.35, date: October 13, 2025).

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