Attitudes to radiation safety and cholangiogram interpretation in endoscopic retrograde cholangiopancreatography (ERCP): a UK survey

Abstract

BackgroundFluoroscopy during endoscopic retrograde cholangiopancreatography (ERCP) exposes staff and patients to potentially harmful ionizing radiation. We performed a UK survey to explore trainee and trainer attitudes to radiation protection and cholangiogram interpretation in ERCP.MethodsAn electronic 10-point survey was prospectively distributed to endoscopy unit leads, training programme directors between October and November 2019. Only UK-based ERCP trainees and trainers with hands-on procedural exposure were eligible for the survey.ResultsThe survey was completed by 107 respondents (58 trainees and 49 trainers), with an estimated overall response rate of 46%. Overall, 49% of respondents were up to date with their radiation protection course, 38% were aware of European Basic safety standards directive (BSSD), 38% wore radiation protection goggles, and 40% were aware of the average radiation screening dose per ERCP procedure. Compared with trainers, trainees were less likely to routinely wear thyroid protection shields (76% vs 92%; p=0.028), have awareness of the BSSD (20% vs 49%; p=0.037) or know their average procedural radiation dosages (21% vs 63%; p<0.001). With regard to cholangiogram interpretation, only 26% had received formal training, with 97% of trainees expressing a desire for further training.ConclusionThis survey highlights a relative complacency in safety attitudes to radiation protection during ERCP. These data provide impetus to improve training and quality assurance in radiation protection, which should be regarded as a mandatory safety aspect prior to commencing hands-on ERCP training.

Patient Radiation Exposure during Enteroscopy-Assisted Endoscopic Retrograde Cholangiopancreatography in Surgically Altered Anatomy (with Video)

“…Therefore, rigorous and continuous education in radiation safety is a mandatory aspect of ERCP training, focusing on parameters that minimize patient radiation exposure. The use of pulsed fluoroscopy, frame rate modification and collimation is strongly recommended to continuously reduce patient radiation exposure during ERCP procedures [22,23]. However, several studies have highlighted the lack of and the need for correct education in radiation protection during ERCP training [22,23].…”

“…The use of pulsed fluoroscopy, frame rate modification and collimation is strongly recommended to continuously reduce patient radiation exposure during ERCP procedures [22,23]. However, several studies have highlighted the lack of and the need for correct education in radiation protection during ERCP training [22,23].…”

Increased ERCP volume improves cholangiogram interpretation: a new performance measure for ERCP training?

“… 22 , 23 Indeed, this does appear to be a concern for ERCP trainees; a recent survey study reported that only 26% of trainees received formal training and 97% expressed a desire for further training. 24 Therefore, maximizing operator cholangiogram interpretation is imperative to maximize the therapeutic efficacy of ERCP.…”

The Effect of Radiation on Nurses Working in Endoscopic Retrograde Cholangiopancreatography

“…The researchers collected the data online via Google Form, which was prepared in line with the literature (hong & Shin, 2014;Siau et al, 2021;Yun & park, 2020) and included questions related to the subject. The form consisted of 30 questions including descriptive characteristics of nurses and the effect of radiation on ERcp nurses.…”