Mo1434 Comparison Between Continuous Infusion and Intermittent Bolus Injection of Propofol for Deep Sedation During Endoscopic Retrograde Cholangiopancreatography: a Preliminary Prospective Randomized Study

62 patients, age range between 35 -87 years underwent endoscopic resection of ampullary lesions. 21 patients had ampullary lesions 30mm in size. All patients had complete ampullary lesion resection in a single session. 21 cases had Paris classification 0-IIa 1s, whilst 31and 10 cases were classified Paris 0-Is and Paris 0-IIa respectively. GAEPE lesions ranged between 30-80mm. Histology confirmed 57 cases of papillary adenomas, 1 case of a gangliocytic paraganglionoma, 2 cases of adenomyomatous hyperplasia and 2 cases ampullary adenocarcinoma. Adjunctive soft coagulation for ablation of adenomatous tissue was used in 5 cases. Bleeding complicated 11 cases, of which only 2 cases required blood transfusions. There were 3 procedure related cases of pancreatitis, 1 migrated pancreatic duct stent, 1 Mallory Weis tear and 1 intra mural contract injection. 53 cases were due follow up at 4 months, where there were 14 cases of adenoma recurrence, which were easily treated by endoscopic snare resection. Bleeding (n 7), pancreatitis (n 1), abdominal pain (n 2) and stent migration (n 1) accounted for 23 additional days of hospitalization. Conclusion: Single session endoscopic resection of carefully staged ampullary lesions, can be undertaken safely with relatively low complication rates. Adenoma recurrence rate at 4 months was low, and were easily treated by snare resection.References: Hopper et al. Gastrointestinal Endosc; 71, 6:967-975.