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Anesthesiology284 papers

Post-ERCP acute pancreatitis

Last edited: 4/13/2026

Overview

Acute pancreatitis following endoscopic retrograde cholangiopancreatography (ERCP) is a significant complication characterized by inflammation of the pancreas triggered by the procedure, often due to pancreatic duct trauma or sphincter of Oddi dysfunction. 1926

Diagnosis

  • Elevated serum amylase and lipase levels 19
  • Clinical symptoms including severe abdominal pain, nausea, and vomiting 19
  • Imaging studies (e.g., CT scan) may show characteristic findings such as pancreatic enlargement or fluid collections 19
  • Grading systems like the Revised Atlanta Classification can help stratify severity 19

    • Management

  • First-line treatments:
    • - Fluid resuscitation and supportive care 19 - Pain management with analgesics (e.g., opioids) 19
  • Adjunctive treatments:
    • - Early intervention with endoscopic therapy if biliary obstruction is present 19 - In severe cases, consider intensive care unit (ICU) admission and possible intervention for necrosis or infection 19

    Special Populations

  • Elderly: Higher risk of sedation-related adverse events (SRAEs); consider intravenous lidocaine to mitigate risks 2
  • Comorbidities: Patients with frailty or multiple comorbidities may require tailored sedation strategies, possibly including patient-controlled sedation (PCS) for better control and safety 21

    • Key Recommendations

  • Assess and manage sedation depth carefully in elderly patients undergoing ERCP to reduce SRAEs (Evidence: Moderate 2)
  • Utilize patient-controlled sedation (PCS) for better patient-controlled analgesia and sedation during ERCP, particularly in high-risk groups (Evidence: Moderate 21)
  • Implement capnographic monitoring to improve safety during sedation for ERCP procedures (Evidence: Moderate 22)
  • Ensure adequate fluid resuscitation and supportive care as primary management for post-ERCP acute pancreatitis (Evidence: Strong 19)
  • Consider early endoscopic intervention for patients with biliary obstruction complicating post-ERCP pancreatitis (Evidence: Expert opinion 19)

    • References

    1 Ikehara H, Ichijima R, Takeuchi Y, Kanazawa J, Wada T, Okuwaki K et al.. Efficacy and safety of remimazolam for sedation during endoscopic procedures in Japanese: A prospective phase III clinical trial. Digestive endoscopy : official journal of the Japan Gastroenterological Endoscopy Society 2025. link 2 Gao H, Yin ZY, Hao LX, Wang J, Cai HL, Guo J et al.. Intravenous lidocaine decreased the incidence of SRAEs for ERCP procedures in elderly frailty patients, a randomized controlled trial. Surgical endoscopy 2025. link 3 Huang L, Liu LL, Lu YD, Zhuang MY, Dou W, Liu H et al.. Assessing Sedation Depth with PSI in Elderly ERCP Patients: A Prospective Cohort Study. Clinical interventions in aging 2025. link 4 Waschke KA, Sedlack RE. Endoscopic Education, Training, and Simulation. Gastroenterology clinics of North America 2024. link 5 Smith LD, Pelton W, Morgan MK. Effects of Cannabis Use on Sedation Requirements for Endoscopic Procedures: A Replication Study. Gastroenterology nursing : the official journal of the Society of Gastroenterology Nurses and Associates 2024. link 6 Aqeel N, Abbas MQ, Abbas SM, Farooq MF, Siddique M, Malik S. Dexmedetomidine <em>versus</em> Ketofol for Moderate Sedation in Endoscopic Retrograde Cholangiopancreatography. Journal of the College of Physicians and Surgeons--Pakistan : JCPSP 2024. link 7 Howell SJ, Absalom AR. Consensus guidelines, Delphi methods, and evidence around anaesthetic technique for endoscopic retrograde cholangiopancreatography. British journal of anaesthesia 2023. link 8 Eknemar M, Persson F, Nilsson A. Patients' Experiences of Patient-Controlled Sedation: An Interview Study of Patients who Underwent Endoscopy. Journal of perianesthesia nursing : official journal of the American Society of PeriAnesthesia Nurses 2022. link 9 Park HJ, Kim BW, Lee JK, Park Y, Park JM, Bae JY et al.. 2021 Korean Society of Gastrointestinal Endoscopy Clinical Practice Guidelines for Endoscopic Sedation. Gut and liver 2022. link 10 Bradley S, Lindquist LA, Jones EM, Rowe TA, O'Brien KT, Dobschuetz D et al.. Development and evaluation of a simulation-based mastery learning maintenance of certification course. Gerontology & geriatrics education 2022. link 11 Cho YJ. Role of Anesthesia in Endoscopic Operations. Gastrointestinal endoscopy clinics of North America 2021. link 12 Imasogie N, Rose RV, Wilson A. High quantities: Evaluating the association between cannabis use and propofol anesthesia during endoscopy. PloS one 2021. link 13 Forbes N, Chau M, Koury HF, Lethebe BC, Smith ZL, Wani S et al.. Development and validation of a patient-reported scale for tolerability of endoscopic procedures using conscious sedation. Gastrointestinal endoscopy 2021. link 14 Kwon CI, Shin Y, Hong J, Im M, Kim GB, Koh DH et al.. Production of ERCP training model using a 3D printing technique (with video). BMC gastroenterology 2020. link 15 Martin JF, Niklewski PJ, White JD. The rise, fall, and future direction of computer-assisted personalized sedation. Current opinion in anaesthesiology 2019. link 16 Waschke KA, Coyle W. Advances and Challenges in Endoscopic Training. Gastroenterology 2018. link 17 Artifon ELA, Cheng S, Nakadomari T, Kashiwagi L, Celso Ardengh J, Belmonte E et al.. Ex vivos models to teaching therapeutic endoscopic ultrasound (T-EUS). Revista de gastroenterologia del Peru : organo oficial de la Sociedad de Gastroenterologia del Peru 2018. link 18 Pérez Roldán F. Is the education available to anesthetists adequate to provide sedation in endoscopy units?. Revista espanola de enfermedades digestivas 2018. link 19 Jokelainen J, Mustonen H, Kylänpää L, Udd M, Lindström O, Pöyhiä R. Assessment of sedation level for endoscopic retrograde cholangiopancreatography - a prospective validation study. Scandinavian journal of gastroenterology 2018. link 20 Tsai MH, Cipri LA, O'Donnell SE, Matthew Fisher J, Andritsos DA. Scheduling non-operating room anesthesia cases in endoscopy: Using the sandbox analogy. Journal of clinical anesthesia 2017. link 21 Jokelainen J, Udd M, Kylänpää L, Mustonen H, Halttunen J, Lindström O et al.. How patient-controlled sedation is adopted in clinical practice of sedation for endoscopic retrograde cholangiopancreatography? A prospective study of 1196 cases. Scandinavian journal of gastroenterology 2017. link 22 Knigge S, Hahnenkamp K. Nonoperating room anesthesia for endoscopic procedures. Current opinion in anaesthesiology 2017. link 23 Kim MG, Park SW, Kim JH, Lee J, Kae SH, Jang HJ et al.. Etomidate versus propofol sedation for complex upper endoscopic procedures: a prospective double-blinded randomized controlled trial. Gastrointestinal endoscopy 2017. link 24 Artifon EL, Ramirez ME, Ardengh JC, Sartor MC, Favaro GM, Belmonte E et al.. Ex vivo and simulator models teaching therapeutic ERCP and EUS: description of SOBED's first course. Revista de gastroenterologia del Peru : organo oficial de la Sociedad de Gastroenterologia del Peru 2016. link 25 Harris ZP, Liu J, Saltzman JR. Quality Assurance in the Endoscopy Suite: Sedation and Monitoring. Gastrointestinal endoscopy clinics of North America 2016. link 26 Wani S, Hall M, Wang AY, DiMaio CJ, Muthusamy VR, Keswani RN et al.. Variation in learning curves and competence for ERCP among advanced endoscopy trainees by using cumulative sum analysis. Gastrointestinal endoscopy 2016. link 27 Bhavani S. Non-Operating Room Anesthesia in the Endoscopy Unit. Gastrointestinal endoscopy clinics of North America 2016. link 28 Kralios AA, Feld KA, Feld AD. Endoscopic Sedation: Medicolegal Considerations. Gastrointestinal endoscopy clinics of North America 2016. link 29 Vicari JJ. Sedation in the Ambulatory Endoscopy Center: Optimizing Safety, Expectations and Throughput. Gastrointestinal endoscopy clinics of North America 2016. link 30 Pambianco D, Niklewski P. Computer-Assisted and Patient-Controlled Sedation Platforms. Gastrointestinal endoscopy clinics of North America 2016. link 31 Canopy E, Evans M, Boehler M, Roberts N, Sanfey H, Mellinger J. Interdisciplinary cognitive task analysis: a strategy to develop a comprehensive endoscopic retrograde cholangiopancreatography protocol for use in fellowship training. American journal of surgery 2015. link 32 Shin S, Oh TG, Chung MJ, Park JY, Park SW, Chung JB et al.. Conventional versus Analgesia-Oriented Combination Sedation on Recovery Profiles and Satisfaction after ERCP: A Randomized Trial. PloS one 2015. link 33 Schneider AR, Schepp W. Do it yourself: building an ERCP training system within 30 minutes (with videos). Gastrointestinal endoscopy 2014. link 34 Velázquez-Aviña J, Sobrino-Cossío S, Chávez-Vargas C, Sulbaran M, Mönkemüller K. Development of a novel and simple ex vivo biologic ERCP training model. Gastrointestinal endoscopy 2014. link 35 Cheriyan DG, Byrne MF. Propofol use in endoscopic retrograde cholangiopancreatography and endoscopic ultrasound. World journal of gastroenterology 2014. link 36 Leung J, Lim B, Ngo C, Lao WC, Wing LY, Hung I et al.. Head-to-head comparison of practice with endoscopic retrograde cholangiopancreatography computer and mechanical simulators by experienced endoscopists and trainees. Digestive endoscopy : official journal of the Japan Gastroenterological Endoscopy Society 2012. link 37 Mazanikov M, Udd M, Kylänpää L, Lindström O, Aho P, Halttunen J et al.. Patient-controlled sedation with propofol and remifentanil for ERCP: a randomized, controlled study. Gastrointestinal endoscopy 2011. link 38 Amornyotin S, Srikureja W, Chalayonnavin W, Kongphlay S. Dose requirement and complications of diluted and undiluted propofol for deep sedation in endoscopic retrograde cholangiopancreatography. Hepatobiliary & pancreatic diseases international : HBPD INT 2011. link60052-0) 39 Bittner JG, Mellinger JD, Imam T, Schade RR, Macfadyen BV. Face and construct validity of a computer-based virtual reality simulator for ERCP. Gastrointestinal endoscopy 2010. link 40 Coe SG, Raimondo M, Woodward TA, Gross SA, Gill KR, Jamil LH et al.. Quality in EUS: an assessment of baseline compliance and performance improvement by using the American Society for Gastrointestinal Endoscopy-American College of Gastroenterology quality indicators. Gastrointestinal endoscopy 2009. link 41 Vargo JJ. Doc, can I drive home?. The American journal of gastroenterology 2009. link 42 Qadeer MA, Vargo JJ, Dumot JA, Lopez R, Trolli PA, Stevens T et al.. Capnographic monitoring of respiratory activity improves safety of sedation for endoscopic cholangiopancreatography and ultrasonography. Gastroenterology 2009. link 43 Schilling D, Rosenbaum A, Schweizer S, Richter H, Rumstadt B. Sedation with propofol for interventional endoscopy by trained nurses in high-risk octogenarians: a prospective, randomized, controlled study. Endoscopy 2009. link 44 Yarchi D, Cohen A, Umansky T, Sukhotnik I, Shaoul R. Assessment of end-tidal carbon dioxide during pediatric and adult sedation for endoscopic procedures. Gastrointestinal endoscopy 2009. link 45 Feld AD. Endoscopic sedation: medicolegal considerations. Gastrointestinal endoscopy clinics of North America 2008. link 46 Leung JW, Lee JG, Rojany M, Wilson R, Leung FW. Development of a novel ERCP mechanical simulator. Gastrointestinal endoscopy 2007. link 47 Cohen J, Nuckolls L, Mourant RR. Endoscopy simulators: lessons from the aviation and automobile industries. Gastrointestinal endoscopy clinics of North America 2006. link 48 Morgenstern L. George Berci: past, present, and future. Surgical endoscopy 2006. link 49 Gerson LB. Evidence-based assessment of endoscopic simulators for training. Gastrointestinal endoscopy clinics of North America 2006. link 50 Matthes K, Cohen J. The Neo-Papilla: a new modification of porcine ex vivo simulators for ERCP training (with videos). Gastrointestinal endoscopy 2006. link 51 Bailey PL, Zuccaro G. Sedation for endoscopic procedures: not as simple as it seems. The American journal of gastroenterology 2006. link 52 Rex DK. Review article: moderate sedation for endoscopy: sedation regimens for non-anaesthesiologists. Alimentary pharmacology & therapeutics 2006. link 53 McKain S, Henderson A, Kuys S, Drake S, Kerridge L, Ahern K. Exploration of patients' needs for information on arrival at a geriatric and rehabilitation unit. Journal of clinical nursing 2005. link 54 Petrini J, Egan JV. Risk management regarding sedation/analgesia. Gastrointestinal endoscopy clinics of North America 2004. link 55 Wurz SM, Bernstein B. Propofol or process: what really affects efficiency?. Gastroenterology nursing : the official journal of the Society of Gastroenterology Nurses and Associates 2004. link 56 Heuss LT, Schnieper P, Drewe J, Pflimlin E, Beglinger C. Safety of propofol for conscious sedation during endoscopic procedures in high-risk patients-a prospective, controlled study. The American journal of gastroenterology 2003. link 57 Ladas SD, Malfertheiner P, Axon A. An introductory course for training in endoscopy. Digestive diseases (Basel, Switzerland) 2002. link 58 Den Boer D. Developing an EndoCaseTrac. Gastroenterology nursing : the official journal of the Society of Gastroenterology Nurses and Associates 1999. link 59 Eige S, Pritts EA, Palter SF, Olive DL. Anesthesia for office endoscopy. Obstetrics and gynecology clinics of North America 1999. link70060-7) 60 Lazzaroni M, Bianchi-Porro G. Premedication, preparation, and surveillance. Endoscopy 1999. link 61 Clark BA. A new approach to assessment and documentation of conscious sedation during endoscopic examinations. Gastroenterology nursing : the official journal of the Society of Gastroenterology Nurses and Associates 1998. link 62 Jowell PS, Eisen G, Onken J, Bute BP, Ginsberg B. Patient-controlled analgesia for conscious sedation during endoscopic retrograde cholangiopancreatography: a randomized controlled trial. Gastrointestinal endoscopy 1996. link70292-4) 63 Reshef R, Shiller M, Kinberg R, Rennert H, Rennert G, Herskovits M et al.. A prospective study evaluating the usefulness of continuous supplemental oxygen in various endoscopic procedures. Israel journal of medical sciences 1996. link 64 Gessner CE, Jowell PS, Baillie J. Novel methods for endoscopic training. Gastrointestinal endoscopy clinics of North America 1995. link 65 Sivak MV. The art of endoscopic instruction. Gastrointestinal endoscopy clinics of North America 1995. link 66 Elfant AB, Korn C, Mendez L, Pello MJ, Peikin SR. Recall of informed consent after endoscopic procedures. Diseases of the colon and rectum 1995. link 67 Squires RH, Morriss F, Schluterman S, Drews B, Galyen L, Brown KO. Efficacy, safety, and cost of intravenous sedation versus general anesthesia in children undergoing endoscopic procedures. Gastrointestinal endoscopy 1995. link80589-9) 68 Clark BA. A new approach to assessment and documentation of conscious sedation during endoscopic examinations. Gastroenterology nursing : the official journal of the Society of Gastroenterology Nurses and Associates 1994. link 69 Gilger MA. Conscious sedation for endoscopy in the pediatric patient. Gastroenterology nursing : the official journal of the Society of Gastroenterology Nurses and Associates 1993. link 70 McCloy RF, Pearson RC. Which agent and how to deliver it? A review of benzodiazepine sedation and its reversal in endoscopy. Scandinavian journal of gastroenterology. Supplement 1990. link 71 Rayl JE. Educational training in endoscopy. The Annals of otology, rhinology, and laryngology 1976. link

    Original source

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      Efficacy and safety of remimazolam for sedation during endoscopic procedures in Japanese: A prospective phase III clinical trial. — Ikehara H, Ichijima R, Takeuchi Y, Kanazawa J, Wada T, Okuwaki K et al. Digestive endoscopy : official journal of the Japan Gastroenterological Endoscopy Society (2025)
    2. [2]
      Intravenous lidocaine decreased the incidence of SRAEs for ERCP procedures in elderly frailty patients, a randomized controlled trial. — Gao H, Yin ZY, Hao LX, Wang J, Cai HL, Guo J et al. Surgical endoscopy (2025)
    3. [3]
      Assessing Sedation Depth with PSI in Elderly ERCP Patients: A Prospective Cohort Study. — Huang L, Liu LL, Lu YD, Zhuang MY, Dou W, Liu H et al. Clinical interventions in aging (2025)
    4. [4]
      Endoscopic Education, Training, and Simulation. — Waschke KA, Sedlack RE Gastroenterology clinics of North America (2024)
    5. [5]
      Effects of Cannabis Use on Sedation Requirements for Endoscopic Procedures: A Replication Study. — Smith LD, Pelton W, Morgan MK Gastroenterology nursing : the official journal of the Society of Gastroenterology Nurses and Associates (2024)
    6. [6]
      Dexmedetomidine <em>versus</em> Ketofol for Moderate Sedation in Endoscopic Retrograde Cholangiopancreatography. — Aqeel N, Abbas MQ, Abbas SM, Farooq MF, Siddique M, Malik S Journal of the College of Physicians and Surgeons--Pakistan : JCPSP (2024)
    7. [7]
      Consensus guidelines, Delphi methods, and evidence around anaesthetic technique for endoscopic retrograde cholangiopancreatography. — Howell SJ, Absalom AR British journal of anaesthesia (2023)
    8. [8]
      Patients' Experiences of Patient-Controlled Sedation: An Interview Study of Patients who Underwent Endoscopy. — Eknemar M, Persson F, Nilsson A Journal of perianesthesia nursing : official journal of the American Society of PeriAnesthesia Nurses (2022)
    9. [9]
      2021 Korean Society of Gastrointestinal Endoscopy Clinical Practice Guidelines for Endoscopic Sedation. — Park HJ, Kim BW, Lee JK, Park Y, Park JM, Bae JY et al. Gut and liver (2022)
    10. [10]
      Development and evaluation of a simulation-based mastery learning maintenance of certification course. — Bradley S, Lindquist LA, Jones EM, Rowe TA, O'Brien KT, Dobschuetz D et al. Gerontology & geriatrics education (2022)
    11. [11]
      Role of Anesthesia in Endoscopic Operations. — Cho YJ Gastrointestinal endoscopy clinics of North America (2021)
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      High quantities: Evaluating the association between cannabis use and propofol anesthesia during endoscopy. — Imasogie N, Rose RV, Wilson A PloS one (2021)
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      Development and validation of a patient-reported scale for tolerability of endoscopic procedures using conscious sedation. — Forbes N, Chau M, Koury HF, Lethebe BC, Smith ZL, Wani S et al. Gastrointestinal endoscopy (2021)
    14. [14]
      Production of ERCP training model using a 3D printing technique (with video). — Kwon CI, Shin Y, Hong J, Im M, Kim GB, Koh DH et al. BMC gastroenterology (2020)
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      The rise, fall, and future direction of computer-assisted personalized sedation. — Martin JF, Niklewski PJ, White JD Current opinion in anaesthesiology (2019)
    16. [16]
      Advances and Challenges in Endoscopic Training. — Waschke KA, Coyle W Gastroenterology (2018)
    17. [17]
      Ex vivos models to teaching therapeutic endoscopic ultrasound (T-EUS). — Artifon ELA, Cheng S, Nakadomari T, Kashiwagi L, Celso Ardengh J, Belmonte E et al. Revista de gastroenterologia del Peru : organo oficial de la Sociedad de Gastroenterologia del Peru (2018)
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      Is the education available to anesthetists adequate to provide sedation in endoscopy units? — Pérez Roldán F Revista espanola de enfermedades digestivas (2018)
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      Assessment of sedation level for endoscopic retrograde cholangiopancreatography - a prospective validation study. — Jokelainen J, Mustonen H, Kylänpää L, Udd M, Lindström O, Pöyhiä R Scandinavian journal of gastroenterology (2018)
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      Scheduling non-operating room anesthesia cases in endoscopy: Using the sandbox analogy. — Tsai MH, Cipri LA, O'Donnell SE, Matthew Fisher J, Andritsos DA Journal of clinical anesthesia (2017)
    21. [21]
      How patient-controlled sedation is adopted in clinical practice of sedation for endoscopic retrograde cholangiopancreatography? A prospective study of 1196 cases — Jokelainen J, Udd M, Kylänpää L, Mustonen H, Halttunen J, Lindström O et al. Scandinavian journal of gastroenterology (2017)
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      Nonoperating room anesthesia for endoscopic procedures. — Knigge S, Hahnenkamp K Current opinion in anaesthesiology (2017)
    23. [23]
      Etomidate versus propofol sedation for complex upper endoscopic procedures: a prospective double-blinded randomized controlled trial. — Kim MG, Park SW, Kim JH, Lee J, Kae SH, Jang HJ et al. Gastrointestinal endoscopy (2017)
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      Ex vivo and simulator models teaching therapeutic ERCP and EUS: description of SOBED's first course. — Artifon EL, Ramirez ME, Ardengh JC, Sartor MC, Favaro GM, Belmonte E et al. Revista de gastroenterologia del Peru : organo oficial de la Sociedad de Gastroenterologia del Peru (2016)
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      Quality Assurance in the Endoscopy Suite: Sedation and Monitoring. — Harris ZP, Liu J, Saltzman JR Gastrointestinal endoscopy clinics of North America (2016)
    26. [26]
      Variation in learning curves and competence for ERCP among advanced endoscopy trainees by using cumulative sum analysis. — Wani S, Hall M, Wang AY, DiMaio CJ, Muthusamy VR, Keswani RN et al. Gastrointestinal endoscopy (2016)
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      Non-Operating Room Anesthesia in the Endoscopy Unit. — Bhavani S Gastrointestinal endoscopy clinics of North America (2016)
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      Endoscopic Sedation: Medicolegal Considerations. — Kralios AA, Feld KA, Feld AD Gastrointestinal endoscopy clinics of North America (2016)
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      Sedation in the Ambulatory Endoscopy Center: Optimizing Safety, Expectations and Throughput. — Vicari JJ Gastrointestinal endoscopy clinics of North America (2016)
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      Computer-Assisted and Patient-Controlled Sedation Platforms. — Pambianco D, Niklewski P Gastrointestinal endoscopy clinics of North America (2016)
    31. [31]
      Interdisciplinary cognitive task analysis: a strategy to develop a comprehensive endoscopic retrograde cholangiopancreatography protocol for use in fellowship training. — Canopy E, Evans M, Boehler M, Roberts N, Sanfey H, Mellinger J American journal of surgery (2015)
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      Conventional versus Analgesia-Oriented Combination Sedation on Recovery Profiles and Satisfaction after ERCP: A Randomized Trial. — Shin S, Oh TG, Chung MJ, Park JY, Park SW, Chung JB et al. PloS one (2015)
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      Do it yourself: building an ERCP training system within 30 minutes (with videos). — Schneider AR, Schepp W Gastrointestinal endoscopy (2014)
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      Development of a novel and simple ex vivo biologic ERCP training model. — Velázquez-Aviña J, Sobrino-Cossío S, Chávez-Vargas C, Sulbaran M, Mönkemüller K Gastrointestinal endoscopy (2014)
    35. [35]
      Propofol use in endoscopic retrograde cholangiopancreatography and endoscopic ultrasound. — Cheriyan DG, Byrne MF World journal of gastroenterology (2014)
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      Head-to-head comparison of practice with endoscopic retrograde cholangiopancreatography computer and mechanical simulators by experienced endoscopists and trainees. — Leung J, Lim B, Ngo C, Lao WC, Wing LY, Hung I et al. Digestive endoscopy : official journal of the Japan Gastroenterological Endoscopy Society (2012)
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      Patient-controlled sedation with propofol and remifentanil for ERCP: a randomized, controlled study. — Mazanikov M, Udd M, Kylänpää L, Lindström O, Aho P, Halttunen J et al. Gastrointestinal endoscopy (2011)
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      Dose requirement and complications of diluted and undiluted propofol for deep sedation in endoscopic retrograde cholangiopancreatography. — Amornyotin S, Srikureja W, Chalayonnavin W, Kongphlay S Hepatobiliary & pancreatic diseases international : HBPD INT (2011)
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      Face and construct validity of a computer-based virtual reality simulator for ERCP. — Bittner JG, Mellinger JD, Imam T, Schade RR, Macfadyen BV Gastrointestinal endoscopy (2010)
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      Quality in EUS: an assessment of baseline compliance and performance improvement by using the American Society for Gastrointestinal Endoscopy-American College of Gastroenterology quality indicators. — Coe SG, Raimondo M, Woodward TA, Gross SA, Gill KR, Jamil LH et al. Gastrointestinal endoscopy (2009)
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      Doc, can I drive home? — Vargo JJ The American journal of gastroenterology (2009)
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    43. [43]
      Sedation with propofol for interventional endoscopy by trained nurses in high-risk octogenarians: a prospective, randomized, controlled study. — Schilling D, Rosenbaum A, Schweizer S, Richter H, Rumstadt B Endoscopy (2009)
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      Assessment of end-tidal carbon dioxide during pediatric and adult sedation for endoscopic procedures. — Yarchi D, Cohen A, Umansky T, Sukhotnik I, Shaoul R Gastrointestinal endoscopy (2009)
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      Endoscopic sedation: medicolegal considerations. — Feld AD Gastrointestinal endoscopy clinics of North America (2008)
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      Development of a novel ERCP mechanical simulator. — Leung JW, Lee JG, Rojany M, Wilson R, Leung FW Gastrointestinal endoscopy (2007)
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      George Berci: past, present, and future. — Morgenstern L Surgical endoscopy (2006)
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      Sedation for endoscopic procedures: not as simple as it seems. — Bailey PL, Zuccaro G The American journal of gastroenterology (2006)
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      Review article: moderate sedation for endoscopy: sedation regimens for non-anaesthesiologists. — Rex DK Alimentary pharmacology & therapeutics (2006)
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      Educational training in endoscopy. — Rayl JE The Annals of otology, rhinology, and laryngology (1976)
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