ERCP in seriously ill patient using specialized laryngeal mask

INTRODUCTION ERCP in seriously ill patients consists of a challenge in invasive Gastroenterology due to the fact that it is mainly performed under intubation-general anesthesia with the potential respiratory and other risks.

AIM We present a patient suffering from suppurative cholangitis who underwent ERCP with the use of a specialized laryngeal mask.

METHOD A 98-years old female patient with a history of CAD, DM II, COPD, NYHA III heart failure under dual-antiplatelet therapy has been hospitalised due to suppurative cholangitis complicated by Systemic Inflammatory Response Syndrome (SIRS). She underwent cross-imaging (CT/MRI) which revealed an impacted common bile duct and an ERCP was scheduled. Given the increased risk of post-ERCP respiratory complications, it was decided to apply deep sedation with the use of a specialized laryngeal maskwith an integrated endoscope channel instead of general anesthesia. The common bile duct was drained with the use of a plastic stent. A few days later after satisfactory clinical improvement the patient underwent a second 'regular' ERCP where the bile duct stone was completely removed uneventfully.

CONCLUSION The use of a specialized laryngeal mask with an integrated endoscope channel during ERCP in seriously ill patients could be a safe and effective alternative treatment for avoidance of intubation and its potential complications.

Publication History

Article published online:
27 March 2025