We hypothesized that in patients undergoing elective hepatobiliary-pancreatic surgery, the group in which anesthesia is induced and maintained with remimazolam during surgery would maintain hemodynamic stability and reduce the incidence of postoperative acute kidney injury compared to propofol. The purpose is to provide practical evidence for perioperative management differentiated from other surgeries for hepatobiliary-pancreatic surgery patients for whom intraoperative fluid therapy is restricted.

Inclusion Criteria:

• Ages 19 or older and under 85
• Patients scheduled to undergo elective hepatopancreatic surgery under general anesthesia
• American Society of Anesthesiologists (ASA) physical grade 1-3
• Those who voluntarily consented to a written informed consent form prior to participation in the study

Exclusion Criteria:

• Patients with hypersensitivity to other benzodiazepine drugs, including remimazolam, and to the components of this drug (e.g., patients with severe hypersensitivity to dextran 40)
• Patients with hypersensitivity to propofol
• Patients with underlying conditions: liver, neurological disorders, or acute narrow-angle glaucoma
• Patients with severe or acute respiratory failure
• Patients in shock or a coma
• Patients taking TCA antidepressants
• Patients with preoperative chronic kidney disease