Endoscopist-directed deep sedation during endoscopic retrograde cholangiopancreatography is safe. The presence of certain factors should be assessed before the procedure to identify patients who are high-risk for difficult sedation.

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Background: Few studies reported on carcinoembryonic antigen (CEA) and carbohydrate antigen 19-9 (CA19-9) as markers for overall survival (OS) and disease free survival (DFS). This study aimed to determine the stage-specific prognostic value of CEA and CA19-9 serum levels at diagnosis on OS and DFS in patients with pancreatic ductal adenocarcinoma (PDAC), discussed at pancreatic Multidisciplinary Team (MDT) meetings. Material and Methods: All consecutive patients with PDAC, discussed at MDT meetings between from 2013 through 2017 at a single tertiary referral center, were retrospectively reviewed. Advanced stage was defined as either locally advanced PDAC or presence of distant metastases. The Kaplan-Meier method was used to estimate the OS and DFS. Prognostic factors were evaluated in uniand multivariable Cox proportional hazard models. Approval of the local Medical Research and Ethical Committee was obtained for this study. Results: 375 patients were available for analyses, of which 151 (40.3%) patients underwent resection and 224 (59.7%) patients had advanced stage PDAC. In the total cohort, both elevated CA19-9 (>305 kU/L) and CEA (>7 mg/L) levels