No difference between supine and prone position for ERCP in conscious sedated patients: a prospective randomized...

Area of Science:

• Gastroenterology
• Endoscopic Procedures
• Patient Safety

Background:

• Endoscopic retrograde cholangiopancreatography (ERCP) is typically performed with patients in the prone or left lateral position.
• The supine position may offer advantages in patient comfort and airway management.
• However, concerns exist regarding potential technical difficulties and increased cardiorespiratory risks in the supine position.

Purpose of the Study:

• To compare the technical aspects and complication rates of ERCP performed in the supine versus prone position.
• To evaluate the influence of patient positioning on ERCP outcomes in a tertiary referral center.

Main Methods:

• A prospective randomized study involving 120 patients undergoing therapeutic ERCP with intact papilla.
• Patients were randomized to either the prone (n=60) or supine (n=60) position under conscious sedation.
• Data collected included cannulation difficulty, procedure duration, cardiorespiratory events, and complications, comparing expert endoscopists with trainees.

Main Results:

• No significant differences in technical parameters or complication rates were observed between the prone and supine positions.
• ERCP success rates were comparable between the two positions, irrespective of operator experience (tutor vs. trainee).

Conclusions:

• ERCP can be performed with similar success rates and complication profiles in both prone and supine positions.
• Operator training and technique are crucial for successful ERCP, regardless of patient positioning.