Radiation exposure in therapeutic endoscopic retrograde cholangiopancreatography with two types of fluoroscopy systems

IF 0.3 Q4 GASTROENTEROLOGY & HEPATOLOGY

Advances in Digestive Medicine Pub Date : 2024-04-24 DOI:10.1002/aid2.13392

Yao‐Sheng Wang, Ying‐Jung Wu, Wan‐Jou Tseng, Chien‐Jui Huang, Chiung‐Yu Chen

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引用次数: 0

Abstract

Fluoroscopy is necessary for endoscopic retrograde cholangiopancreatography (ERCP). Occupational radiation exposure of staff (endoscopists, nurses, or assistants) is inevitable. Fluoroscopes with a tube over‐couch (OC) rather than under‐couch (UC) may have more radiation reflection dosage on the staff's upper body theoretically, where the most vital organs are. In the study, we assessed the radiation exposure on staff by two different types of fluoroscopes in real‐world practice. Using a radiation dosimeter to measure the radiation dosage on endoscopists and assistants in each ERCP procedure under two different fluoroscopic systems (UC vs. OC). Forty‐one ERCP procedures were enrolled. Dosimeters were used NanoDots for the measurement of personal radiation exposure. Those dosimeters were attached to the left forearm and chest of the endoscopist and only the chest of two assistants, the wall of the ERCP room, and the controlling room in every procedure. Nine‐teen ERCPs were performed under the OC unit, and the other 22 ERCPs were UC method. Fluoroscopic time and output of radiation dose showed no significant difference between the two groups. Radiation exposure in endoscopist were 0.0911[0.1041–0.3974] mGy (OC) versus 0.0276 [0.0080–0.2924] mGy (UC), p < .01 for the forearm; and 0.0318 [0.0070–0.2628] mGy (OC) versus 0.0182 [0.0088–0.1628] mGy (UC), p = .04 for the endoscopist's body. There was no difference in radiation exposure from assistants in both groups. For all the ERCP procedures, the measurement of radiation exposure from high to low is endoscopist's hand, endoscopist's body, assistant 1, assistant 2, and ERCP room (p < .01). Radiation detection from ERCP room is slightly higher but close to controlling room (p = .06). For the safety of occupational radiation protection, tube of fluoroscope UC is better than OC for the endoscopists more than assistants. Besides, the assistant 1 took higher radiation exposure than assistant 2 for each ERCP procedure.

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使用两种透视系统进行治疗性内镜逆行胰胆管造影术的辐射量

内镜逆行胰胆管造影术（ERCP）需要使用荧光镜。工作人员（内镜医师、护士或助理）不可避免地会受到职业辐射。从理论上讲，在工作人员的上半身，也就是最重要的器官所在位置，使用管子在膀胱上（OC）而不是在膀胱下（UC）的荧光镜可能会有更多的辐射反射剂量。在这项研究中，我们评估了两种不同类型的荧光透视仪在实际工作中对工作人员造成的辐射量。在两种不同的透视系统（UC 与 OC）下，使用辐射剂量计测量每个 ERCP 程序中内镜医师和助手的辐射剂量。共进行了 41 例 ERCP 手术。剂量计使用 NanoDots 测量个人辐射量。这些剂量计分别安装在内镜医师的左前臂和胸部、两名助手的胸部、ERCP室的墙壁以及每次手术的控制室。其中9-15例ERCP在OC装置下进行，其他22例ERCP采用UC方法。两组的透视时间和辐射剂量输出无明显差异。内镜医师前臂的辐射量为0.0911[0.1041-0.3974] mGy（OC）对0.0276[0.0080-0.2924] mGy（UC），p < .01；内镜医师身体的辐射量为0.0318[0.0070-0.2628] mGy（OC）对0.0182[0.0088-0.1628] mGy（UC），p = .04。两组助手的辐射量没有差异。在所有ERCP手术中，辐射量从高到低依次为内镜医师的手、内镜医师的身体、助手1、助手2和ERCP室（p < .01）。ERCP室的辐射检测值略高，但与控制室接近（p = .06）。就职业辐射防护的安全性而言，对于内镜医师而言，UC荧光管比OC荧光管的效果要好，而对于助理医师而言，UC荧光管比OC荧光管的效果要好。此外，在每次ERCP手术中，助手1的辐射量高于助手2。

本文章由计算机程序翻译，如有差异，请以英文原文为准。

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来源期刊

Advances in Digestive Medicine GASTROENTEROLOGY & HEPATOLOGY-

自引率

33.30%

发文量

期刊介绍： Advances in Digestive Medicine is the official peer-reviewed journal of GEST, DEST and TASL. Missions of AIDM are to enhance the quality of patient care, to promote researches in gastroenterology, endoscopy and hepatology related fields, and to develop platforms for digestive science. Specific areas of interest are included, but not limited to: • Acid-related disease • Small intestinal disease • Digestive cancer • Diagnostic & therapeutic endoscopy • Enteral nutrition • Innovation in endoscopic technology • Functional GI • Hepatitis • GI images • Liver cirrhosis • Gut hormone • NASH • Helicobacter pylori • Cancer screening • IBD • Laparoscopic surgery • Infectious disease of digestive tract • Genetics and metabolic disorder • Microbiota • Regenerative medicine • Pancreaticobiliary disease • Guideline & consensus.