Interventional Radiologist-Directed Sedation Versus General Anesthesia for Percutaneous Biliary Drainage: Effects on...

Area of Science:

• Interventional Radiology
• Anesthesiology
• Gastroenterology

Background:

• Percutaneous biliary drainage is a critical procedure for managing biliary obstructions.
• Anesthesia choice impacts procedural efficiency and patient safety.
• General anesthesia (GA) has been the standard, but alternative sedation methods are being explored.

Purpose of the Study:

• To compare procedural efficiency, hemodynamic stability, analgesic outcomes, and adverse events between interventional radiologist-directed sedation and general anesthesia (GA) for primary percutaneous biliary drainage.

Main Methods:

• Retrospective study of adults undergoing primary percutaneous biliary drainage (2021-2026).
• Compared procedure duration, room turnover times, pain scores, opioid use, and adverse events.
• Analyzed 87 procedures: 42 with radiologist-directed sedation (30 including ketamine) and 45 with GA.

Main Results:

• Procedure duration was similar (36.5 min vs. 43.0 min).
• Radiologist-directed sedation significantly reduced pre- and post-procedure room turnover times (84 min combined reduction).
• Intraoperative hypotension was significantly lower with radiologist-directed sedation (12% vs. 69% with GA).

Conclusions:

• Radiologist-directed sedation is associated with shorter procedure room turnover times.
• This sedation method leads to fewer episodes of intraoperative hypotension compared to GA.
• No significant differences were observed in analgesic outcomes or 30-day complications.