ERCP after a liquid fatty meal: comment

I was very interested by the study by Barrie and Klein recently published in Endoscopy [1], as it describes a very simple and apparently innocuous method of improving cannulation in endoscopic retrograde cholangiopancreatography (ERCP). I would, however, like to point out that the authors did not mention the depth of sedation (light, moderate, or anesthesia), or the drugs used to sedate the patients in the study (some drugs used in sedation for ERCP have a potential to cause contraction of the sphincter of Oddi), or whether the sedation was administered by an anesthesiologist. I would also like to point out that the clear liquid meals ingested 2 h before elective procedures requiring general anesthesia, as recommended by the American Society of Anesthesiology, are intended for children, and that the liquid meal used in the study was intentionally a fatty liquid meal and not a clear liquid one.

I think that such details should be clarified, as this is a potentially very interesting method that could be used in a more generalized fashion in most ERCP examinations.

Reference

• 1 Barrie M, Klein S D, Brown C A. et al . Endoscopic retrograde cholangiopancreatography after a liquid fatty meal: effect on deep common bile duct cannulation time.  Endoscopy. 2006;  38 241-248