Document Detail

Should patients undergoing ERCP be placed in the prone or supine position?
MedLine Citation:
PMID:  18628736     Owner:  NLM     Status:  PubMed-not-MEDLINE    
Endoscopic retrograde cholangiopancreatography (ERCP) is generally performed in the prone or semi-prone position. Compared with the supine position, the left lateral and prone positions are believed to carry a lower risk of aspiration, allow easier intubation of the esophagus and provide a more comfortable position for the endoscopist. However, the supine position might be advantageous for the evaluation of pancreatic and biliary anatomy and for enhanced control of the airway. In this Practice Point commentary, I discuss the findings and limitations of a prospective, randomized study conducted by Tringali et al. that compared the performance of ERCP in the prone and supine positions by both experienced endoscopists and trainees. The results suggest no difference in the difficulty of the procedure on the basis of patient position. Objective measurements including mean time to visualize the papilla and opacification of the desired duct were no different. Likewise, overall technical success and complication rates were equivalent. These results suggest that either the supine or prone positions are adequate for the technical performance of ERCP. This commentary highlights the issues to consider when interpreting and generalizing these results in clinical practice.
C Mel Wilcox
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Publication Detail:
Type:  Comment; Journal Article     Date:  2008-07-15
Journal Detail:
Title:  Nature clinical practice. Gastroenterology & hepatology     Volume:  5     ISSN:  1743-4386     ISO Abbreviation:  -     Publication Date:  2008 Sep 
Date Detail:
Created Date:  2008-09-01     Completed Date:  2009-02-10     Revised Date:  -    
Medline Journal Info:
Nlm Unique ID:  101226510     Medline TA:  Nat Clin Pract Gastroenterol Hepatol     Country:  England    
Other Details:
Languages:  eng     Pagination:  488-9     Citation Subset:  -    
UAB GI Division, University of Alabama, Birmingham, AL 35294-0007, USA.
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Comment On:
Endoscopy. 2008 Feb;40(2):93-7   [PMID:  18058651 ]

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