Endoscopic retrograde cholangiopancreatography has evolved from being a simple diagnostic procedure, performed under proceduralist-administered sedation, to a therapeutic one involving increasingly complex techniques that require a high degree of patient cooperation. The anaesthetist has become a vital member of the team. Many of the patients are medically unfit for surgery. Sedation or general anaesthesia is generally indicated for the increasingly complex, long and painful procedures being performed. Although there is very little published evidence of specific anaesthetic techniques in this area, knowledge of these problems allows the anaesthetist to select an appropriate technique to provide safe and effective anaesthesia.
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