Patient Dose During Therapeutic Endoscopic Retrograde Cholangiopancreatography Procedure

Abstract

Endoscopic retrograde cholangiopancreatography (ERCP) is a standard technique for the diagnosis and treatment of disorders of the pancreas or bile ducts. The aim of this study was the measurement of the radiation dose to patients during therapeutic ERCP procedures, in order to estimate the patient effective dose (ED). Fifteen patients were studied using a fluoroscopy system equipped with automatic brightness control and pulse fluoroscopy mode. Fluoroscopy time (FT), cumulative dose (Ka,r) and air kerma-area product (PKA) were collected for ERCP procedures. The ED was calculated from PKA values. The FT was ranged from 0.68 to 5.57 min, with the mean value of 2.50 min; the Ka,r was ranged from 2.22 to 19.10 mGy, with the mean value of 7.71 mGy; and the PKA was ranged between 0.59 and 5.10 Gycm2, with the mean value of 2.03 Gycm2. The ED ranged from 0.11 to 0.97 mSv, whilst the mean and median ED values were 0.39 and 0.32 mSv, respectively. FT and radiation dose to the patients were either comparative or significantly lower than those previously reported.

Patient radiation dose and fluoroscopy time during ERCP: a single-center, retrospective study of influencing factors

“…Interventions like bile duct dilatation and brushing were identified by multivariate analysis as predictors for longer FT. Furthermore, the multivariate analysis revealed that biliary stent placement was also associated with longer FT, when the diagnosis was removedDiscussionIn recent years, there has been a growing interest generated by research in the field of radiation exposure of both the patient and medical staff during ERCP procedures, as it has been recognized that ERCP requires the same level of radiation protection practice as all other interventional radiological procedures[1,3,4,6,8,9,[14][15][16][17][18][19][20][21][22][23][30][31][32][33][34][35][36][37]. This study was performed to identify factors associated with FT and radiation dose measured by DAP in patients undergoing ERCP in a single tertiary care hospital.…”

Review of air kerma‐area product, effective dose and dose conversion coefficients for non‐cardiac interventional fluoroscopy procedures

“…Among others, Peruzzo Cornetto et al tabulated data for 23 procedures in an Italian hospital, Compagnone et al published data from a different Italian hospital for nine interventional procedures, Dauer et al published P KA data for 43 interventional fluoroscopy procedures at a single U.S. institution, Bundy et al did the same for 12 procedures at a different U.S. medical center, Erskine et al published P KA data for 32 interventional fluoroscopy procedures in Australia, Étard et al’s report contains data from France for 15 procedures, Pitton et al published data for 17 interventional vascular procedures at a German hospital, Schmitz et al reported data on biliary interventions at 23 different facilities, and Ruiz‐Cruces et al reported data for seven interventional procedures performed at eight hospitals in Spain. Many other published studies were also consulted to estimate one or more of P KA , E , and DC E …”

“…Many other published studies were also consulted to estimate one or more of P KA , E, and DC E . 7,11,12,14,15,[17][18][19]21,[24][25][26][27][29][30][31][32][33][34][35][36][37][38][49][50][51][52][53][54][55][56][57][58][59][60][61][62][63] Published values of P KA are included in Table I. Table II provides data for E and Table III provides data for DC E .…”

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

“…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.…”