Review
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World J Gastrointest Endosc. Jul 16, 2011; 3(7): 140-144
Published online Jul 16, 2011. doi: 10.4253/wjge.v3.i7.140
Radiation dose to patients during endoscopic retrograde cholangiopancreatography
Jaume Boix, Vicente Lorenzo-Zúñiga
Jaume Boix, Vicente Lorenzo-Zúñiga, Endoscopy Unit, Department of Gastroenterology, Hospital Universitari Germans Trias i Pujol, Badalona, Barcelona 08916, Spain
Jaume Boix, Vicente Lorenzo-Zúñiga, Centro de Investigación Biomédica en Red de Enfermedades Hepáticas y Digestivas (CIBEREHD), Barcelona 08916, Spain
Author contributions: Boix J and Lorenzo-Zúñiga V contributed equally to this paper.
Correspondence to: Vicente Lorenzo-Zúñiga, MD, PhD, Endoscopy Unit, Department of Gastroenterology, Hospital Universitari Germans Trias i Pujol, Badalona, Barcelona 08916, Spain. vlorenzo.germanstrias@gencat.cat
Telephone: +34-934978866
Received: January 23, 2010
Revised: June 23, 2011
Accepted: July 31, 2011
Published online: July 16, 2011
Abstract

Endoscopic retrograde cholangiopancreatography (ERCP) is an important tool for the diagnosis and treatment of the hepatobiliary system. The use of fluoroscopy to aid ERCP places both the patient and the endoscopy staff at risk of radiation-induced injury. Radiation dose to patients during ERCP depends on many factors, and the endoscopist cannot control some variables, such as patient size, procedure type, or fluoroscopic equipment used. Previous reports have demonstrated a linear relationship between radiation dose and fluoroscopy duration. When fluoroscopy is used to assist ERCP, the shortest fluoroscopy time possible is recommended. Pulsed fluoroscopy and monitoring the length of fluoroscopy have been suggested for an overall reduction in both radiation exposure and fluoroscopy times. Fluoroscopy time is shorter when ERCP is performed by an endoscopist who has many years experience of performing ERCP and carried out a large number of ERCPs in the preceding year. In general, radiation exposure is greater during therapeutic ERCP than during diagnostic ERCP. Factors associated with prolonged fluoroscopy have been delineated recently, but these have not been validated.

Keywords: Endoscopic retrograde cholangiopancreatography, Radiation dose, Fluoroscopy, Radiation exposure, X-ray