BACKGROUND: Fluoroscopy during ERCP has a linear relationship with radiation, carrying risk of exposure. OBJECTIVE: To determine patient, physician, and procedural factors affecting fluoroscopy duration. DESIGN: Prospective analysis of ERCPs with evaluation of patient, physician, and procedural variables. SETTING: Two tertiary-care hospitals. PATIENTS: Consecutive patients undergoing ERCP. INTERVENTIONS: ERCP. MAIN OUTCOME MEASUREMENTS: Variables associated with prolonged fluoroscopy duration. RESULTS: Mean fluoroscopy time (388 ERCPs) was 6.77 minutes (95% CI, 6.15-7.39). No patient factors were found to significantly affect fluoroscopy duration. Fluoroscopy duration was significantly lower for 2 endoscopists compared with the reference endoscopist (average of 4.16 minutes less; 95% CI, -5.48 to -2.48). Multivariable analysis identified variables associated with longer fluoroscopy duration; stent insertion (+3.11 minutes; 95% CI, 1.91-4.30), lithotripsy (+5.74 minutes; 95% CI, 0.931-10.5), needle-knife sphincterotomy (+4.44 minutes; 95% CI, 2.20-6.67), biopsies (+2.11 minutes; 95% CI, 0.025-4.18), use of a guidewire (+1.55 minutes; 95% CI, 0.025-3.07), additional guidewires (+5.61 minutes; 95% CI, 2.69-8.51), and balloon catheter (+4.27 minutes; 95% CI, 3.00-5.53). Mean fluoroscopy duration when a gastroenterology fellow was involved (n = 318) was 7.05 minutes (95% CI, 6.35-7.76) compared with 5.44 minutes (95% CI, 4.26-6.63) when no fellow present (n = 70) (P < .0451). LIMITATIONS: Only 2 centers; others may have different results. Not blinded; investigators may change their practice because fluoroscopy was duration studied. Irrelevance of measuring fluoroscopy duration because endoscopists using protection may not have increased radiation exposure. CONCLUSIONS: In this prospective analysis, factors associated with fluoroscopy duration included endoscopists; stent insertion; lithotripsy; biopsies; use of a needle-knife, guidewire, and balloon catheter; and involvement of a gastroenterology fellow. These identified variables may help endoscopists predict which procedures are associated with prolonged fluoroscopy duration and may lead to appropriate precautions. Copyright 2010 American Society for Gastrointestinal Endoscopy. Published by Mosby, Inc. All rights reserved.
BACKGROUND: Fluoroscopy during ERCP has a linear relationship with radiation, carrying risk of exposure. OBJECTIVE: To determine patient, physician, and procedural factors affecting fluoroscopy duration. DESIGN: Prospective analysis of ERCPs with evaluation of patient, physician, and procedural variables. SETTING: Two tertiary-care hospitals. PATIENTS: Consecutive patients undergoing ERCP. INTERVENTIONS: ERCP. MAIN OUTCOME MEASUREMENTS: Variables associated with prolonged fluoroscopy duration. RESULTS: Mean fluoroscopy time (388 ERCPs) was 6.77 minutes (95% CI, 6.15-7.39). No patient factors were found to significantly affect fluoroscopy duration. Fluoroscopy duration was significantly lower for 2 endoscopists compared with the reference endoscopist (average of 4.16 minutes less; 95% CI, -5.48 to -2.48). Multivariable analysis identified variables associated with longer fluoroscopy duration; stent insertion (+3.11 minutes; 95% CI, 1.91-4.30), lithotripsy (+5.74 minutes; 95% CI, 0.931-10.5), needle-knife sphincterotomy (+4.44 minutes; 95% CI, 2.20-6.67), biopsies (+2.11 minutes; 95% CI, 0.025-4.18), use of a guidewire (+1.55 minutes; 95% CI, 0.025-3.07), additional guidewires (+5.61 minutes; 95% CI, 2.69-8.51), and balloon catheter (+4.27 minutes; 95% CI, 3.00-5.53). Mean fluoroscopy duration when a gastroenterology fellow was involved (n = 318) was 7.05 minutes (95% CI, 6.35-7.76) compared with 5.44 minutes (95% CI, 4.26-6.63) when no fellow present (n = 70) (P < .0451). LIMITATIONS: Only 2 centers; others may have different results. Not blinded; investigators may change their practice because fluoroscopy was duration studied. Irrelevance of measuring fluoroscopy duration because endoscopists using protection may not have increased radiation exposure. CONCLUSIONS: In this prospective analysis, factors associated with fluoroscopy duration included endoscopists; stent insertion; lithotripsy; biopsies; use of a needle-knife, guidewire, and balloon catheter; and involvement of a gastroenterology fellow. These identified variables may help endoscopists predict which procedures are associated with prolonged fluoroscopy duration and may lead to appropriate precautions. Copyright 2010 American Society for Gastrointestinal Endoscopy. Published by Mosby, Inc. All rights reserved.
Authors: Amer A Alkhatib; Ala A Abdel Jalil; Douglas O Faigel; Rahul Pannala; Michael Crowell; M E Harrison Journal: Dig Dis Sci Date: 2015-02-04 Impact factor: 3.199
Authors: Thiruvengadam Muniraj; Harry R Aslanian; Loren Laine; James Farrell; Maria M Ciarleglio; Yanhong Deng; Henry Ho; Priya A Jamidar Journal: Am J Gastroenterol Date: 2015-03-31 Impact factor: 10.864
Authors: Edward Kim; Mark McLoughlin; Eric C Lam; Jack Amar; Michael Byrne; Jennifer Telford; Robert Enns Journal: Can J Gastroenterol Date: 2011-10 Impact factor: 3.522
Authors: Toufic Kachaamy; Edwyn Harrison; Rahul Pannala; William Pavlicek; Michael D Crowell; Douglas O Faigel Journal: World J Gastroenterol Date: 2015-02-14 Impact factor: 5.742
Authors: Chunyan Peng; Paul J Nietert; Peter B Cotton; Daniel T Lackland; Joseph Romagnuolo Journal: BMC Gastroenterol Date: 2013-10-10 Impact factor: 3.067