P207 Is same session EUS & ERCP under conscious sedation associated with less comfort and more adverse events than ERCP alone?

Introduction

Same session EUS and ERCP is increasingly offered because of perceived benefits in avoiding unnecessary ERCP in benign disease and optimising tissue acquisition and staging in malignant disease. There is conflicting evidence mainly from retrospective studies as to whether adverse events are more common. Additionally, there are no studies to date on patient comfort whilst undergoing same session EUS and ERCP under conscious sedation. Our aim is to investigate patient comfort, and adverse events (AE) within 7 days in patients undergoing routine EUS and ERCP in the same session compared to ERCP alone in a tertiary pancreaticobiliary endoscopy unit.

Methods

A prospective audit was performed over a 6-month period in 2022. In addition to patient’s demographic, data was captured re indication, Trainee involvement, EUS duration and performance of biopsy, previous sphincterotomy, time to cannulation, ERCP Schutz grade, type of therapy performed, nurse recorded patient comfort score (Modified Gloucester scale: 1 – 5; no discomfort to extreme discomfort) and all adverse events within 7 days.

Results

203 patients formed the study group 40 (19.6%) underwent same session EUS and ERCP and 163 underwent ERCP alone. Age (median, IQR) was 71 (table 1 summarise the difference between our two study groups.

Conclusion

In an expert centre same session EUS/ERCP can be performed under conscious sedation with high technical success and acceptable sedation dosage. However, nurse reported patient comfort was significantly better for ERCP alone and same session procedures were significantly associated with overall AE. These results provide evidence for the use of deep sedation for same session EUS and ERCP. Further studies are required to investigate the association between same session procedures and AE.