Optimisation of Radiation Exposure to Gastroenterologists and Patients during Therapeutic ERCP

Abstract

This study intended to optimize the radiation doses for gastroenterologists and patients during therapeutic endoscopic retrograde cholangiopancreatography (ERCP) and to compare the doses based on available data obtained by other researchers. A total of 153 patients were studied in two Gastroenterology Departments, (group A, 111; group B, 42). Thermoluminescent dosimeters (TLD) were used to measure the staff and patients entrance surface air kerma (ESAK) at different body sites. The mean ESAK and effective doses per procedure were estimated to be 68.75 mGy and 2.74 mSv, respectively. Staff was exposed to a heterogonous doses. The third examiner (trainee) was exposed to a high dose compared with other examiners because no shield was located to protect him from stray radiation. Patients and examiners doses were lower compared to the lowest values found in previous studies taking into consideration the heterogeneity of patients and equipment. Staff doses during ERCP are within the safety limit in the light of the current practice.

Effectiveness of additional lead shielding to protect staff from scattering radiation during endoscopic retrograde cholangiopancreatography procedures

“…ERCP procedures have lower risks for patients than surgical procedures, and their wide acceptance has led to their increased use [ 1 ]. This is despite the fact that the radiation doses during ERCP are higher than those of any commonly performed diagnostic radiographic imaging [ 9 , 17 , 18 ]. Therefore, radiation protection for the physicians performing ERCP is very important.…”

Radiation exposure to staff during fluoroscopic endoscopic procedures

“…[1][2][3][4][5] Multiple studies indicate that radioprotective eyewear should be a part of the standard PPE due to the high chance of exceeding the lens dose occupational limit. 1,[5][6][7] A further study indicated that compliance with the standard PPE or lead gown and thyroid collar might be a concern, with 27% of endoscopists responding to not wearing thyroid collars and only 10% wearing a radiation monitoring badge. 8 Although several studies report radiation doses to the staff during ERCP procedures, it is difficult to gauge the dose for unmonitored staff.…”

The Establishment of Local Diagnostic Reference Levels in Endoscopic Retrograde Cholangiopancreatography: A Practical Tool for the Optimisation and for Quality Assurance Management

“…(5,7,8) In recent years, there has been a continuing and increasing interest in patient radiation dose particularly from the interventional radiology and cardiology, because of remarkable growth in frequency and complexity of procedures (9)(10)(11)(12)(13) . Several studies have been performed in response to growing interest in patient radiation dose from ERCP as well (7,8,(14)(15)(16)(17)(18)(19)(20) . It is notable, that these interventional procedures may cause a high radiation dose to patients (9) and lead to the radiationinduced skin injuries (21) .…”