Patient and endoscopist radiation doses during ERCP procedures

Abstract

The aim of the study was to calculate radiation doses for patients and staff during interventional Endoscopic retrograde cholangiopancreatography (ERCP) procedures. Patient age (A), kerma-area product (KAP), fluoroscopy time (T) and total number of films (F) were collected for 157 interventional ERCP procedures. One endoscopist (>10 y of experience) monitored using a thermoluminescent dosemeter worn over the lead apron performed the ERCPs. Median (range) KAP was 3.1 Gy cm(-2) (0.1-106.7 Gy cm(-2)). Median (range) A, T and F were 72 y, 2.6 (0.2-26.0) min and 2 (1-4) images, respectively. No correlation was observed between KAP and A, T or F. Monthly endoscopist dose was negligible due to the use of lead apron, collar and two lead-articulated ceiling mounted shields. The endoscopist dose is minimal when using appropriate protective measures. Patient doses showed large variation that has to be further investigated.

Patient and Staff Radiation Exposure during Endoscopic Retrograde Cholangio-Pancreatography: Eight Years of Dose Monitoring

“…A summary of the results (median, mean and maximum values) is shown in Table 1 In Table 2 and Figures 5 and 6, the comparison of median values of the quantities T (min) and KAP (Gy.cm 2 ) is presented, between the results of this study and the corresponding results of similar published data. [3,5,6,10,11]. This is reflected in our results too, as it can be seen in Table 1 and Figure 1, although a single, well-experienced endoscopist, using the same X-ray imaging system, performed all 1632 ECRP procedures.…”

“…The American Society for Gastrointestinal Endoscopy (ASGE) and the American College of Gastroenterology (ACG) established a task force in 2006 to create quality metrics for endoscopy including ERCP [1]. Many studies have tried to estimate the radiation dose delivered to patients and medical staff during ERCP procedures, in hospital centers or even more, to establish local Dose Reference Levels (DRLs) [2][3][4][5][6][7][8][9][10][11][12]. Monitoring the doses reported from ERCP procedures is essential; not only in order to optimize the techniques and protocols in each center, but also to manage the probably increasing radiation dose delivered to patients.…”

ERCP procedures as a source of radiation risk to a single gastroenterologist

“…Należy jednak zaznaczyć, że wyniki podane w pracy [10] pochodzą ze 157 pomiarów wykonanych dawkomierzami termoluminescencyjnymi umieszczonymi na fartuchu operatora i zawierają wkład od fluoroskopii plus 1-4 filmów.…”

“…[9] oraz Tsapaki i wsp. [10] wskazano na znaczenie doświadczenia operatora jako czynnika redukującego poziom narażenia radiacyjnego w zabiegach ECPW.…”

Occupational radiation dose to eyes from endoscopic retrograde cholangiopancreatography procedures in light of the revised eye lens dose limit from the International Commission on Radiological Protection

“…ERCP was initially used as a purely diagnostic procedure; however, over the last two decades, therapeutic applications have been developed [1,2]. Therapeutic procedures typically require longer ñuoroscopy times (than diagnostic procedures) and result in a higher radiation dose [3].…”