ERCP: Time to take the lead off?

Binmoeller, Kenneth F.; Nett, Andrew

doi:10.1016/j.gie.2017.07.019

Cited by 4 publications

(4 citation statements)

References 22 publications

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“…33 Some believed leaders in gastroenterology have strongly embraced the fundamental principles of ALARA, such as advocating for documenting fluoroscopy times in ERCP reports, 7 the use of alternative/adjunctive modalities such as EUS and digital cholangioscopy, 39 and even ERCP without fluoroscopy. 40 However, in most clinical situations ERCP still relies heavily on fluoroscopy for diagnostic and therapeutic purposes.…”

Section: Protecting the Patient Physician And Staffmentioning

confidence: 99%

American Society for Gastrointestinal Endoscopy radiation and fluoroscopy safety in GI endoscopy

Kwok

Hasan

Duloy

et al. 2021

Gastrointestinal Endoscopy

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Section: Protecting the Patient Physician And Staffmentioning

confidence: 99%

American Society for Gastrointestinal Endoscopy radiation and fluoroscopy safety in GI endoscopy

Kwok

Hasan

Duloy

et al. 2021

Gastrointestinal Endoscopy

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“…Initial studies have demonstrated their clinical feasibility and particular relevance to pregnant women, in whom any radiation exposure should be avoided [ 80 - 81 ]. While these radiation-free techniques are promising, they require additional training and commitment towards the evolution of ERCP into a non-radiographic-based procedure [ 82 ].…”

Section: Ercp Radiationmentioning

confidence: 99%

Occupation-associated health hazards for the gastroenterologist/ endoscopist

Ofori

Ramai

John

et al. 2018

aog

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Advances in the field of endoscopy have allowed gastroenterologists to obtain detailed imaging of anatomical structures and to treat gastrointestinal diseases with endoscopic therapies. However, these technological developments have exposed endoscopists and staff to hazards such as musculoskeletal injuries, exposure to infectious agents, and ionizing radiation. We aimed to review the occupational hazards for the gastroenterologist and endoscopist. Using PubMed, Medline, Medscape, and Google Scholar, we identified peer-reviewed articles with the keywords “occupational hazards,” “health hazards,” “occupational health hazards,” “endoscopy,” “gastroenterologist,” “infectious agents,” “musculoskeletal injuries,” and “radiation.” Strategies for reducing exposure to infectious agents, radiation, and the risk of musculoskeletal injuries related to gastroenterology include compliance with established standard measures, the use of thyroid shields and radioprotective eyewear, and ergonomic practices. We conclude that educating endoscopic personnel and trainees in these practices, in addition to further research in these areas, will likely lead to the development of more efficient and user-friendly workspaces that are safer for patients and personnel.

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“…6 Despite this, the understanding of ALARA principles and the adoption of radioprotective personal protective equipment (PPE) remains variable. 7 Moreover, competency in the acquisition and interpretation of cholangiograms are important for successful ERCP and are determinants of radiation exposure. We therefore conducted a nationwide UK survey to explore trainee and trainer attitudes to radiation protection in ERCP, to include aspects of cholangiogram interpretation, and to provide education on the rationale in support of practice considerations behind each survey question.…”

Section: Introductionmentioning

confidence: 99%

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

Siau¹,

Webster

Wright

et al. 2020

Frontline Gastroenterol

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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.

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ERCP: Time to take the lead off?

Cited by 4 publications

References 22 publications

American Society for Gastrointestinal Endoscopy radiation and fluoroscopy safety in GI endoscopy

American Society for Gastrointestinal Endoscopy radiation and fluoroscopy safety in GI endoscopy

Occupation-associated health hazards for the gastroenterologist/ endoscopist

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

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