A Güitrón-Cantú1, R Adalid-Martínez, F K Segura-López. 1. Departamento de Endoscopia Digestiva, Hospital de Especialidades UMAE No 71, Instituto Mexi- cano del Seguro Social, Torreón, Coahuila. aguitron@prodigy.net.mx
Abstract
BACKGROUND: Exposure to radiation during endoscopic retrograde cholangiopancreatography (ERCP) could have adverse effects on the endoscopic team members and patients. There is an inverse relationship between fluoroscopy time and endoscopist experience. OBJECTIVE: To determine the relationship between the technical difficulty to cannulate Vater's papilla, and time to perform the procedure and fluoroscopy time. METHODS: Patients scheduled for ERCP were divided in two groups depending on the degree of difficulty of the process according to Schutz classification: group A (grades 1-3) and group B (grades 4 and 5). We registered demographic variables, reference diagnosis, endoscopic and radiological diagnoses, degree of difficulty to cannulate Vater's papilla (Freeman scale), duration of procedure, fluoroscopy time and endoscopic complications. RESULTS: 213 patients were included: 101 in group A and 112 in group B. Mean fluoroscopy time was 59.15 seconds in group A and 93.59 seconds in group B (p <0.0001). Mean time to perform the procedure was 13.18 minutes in group A and 20.23 minutes in group B (p <0.0001). Factors related to increased fluoroscopy time were technical difficulty for the CPE according to Schutz (p <0.0001), stent placement (p = 0.021) and hydrostatic dilation (p <0.0001). CONCLUSIONS: The fluoroscopy time increased proportionally to technical difficulty to perform the procedure.
BACKGROUND: Exposure to radiation during endoscopic retrograde cholangiopancreatography (ERCP) could have adverse effects on the endoscopic team members and patients. There is an inverse relationship between fluoroscopy time and endoscopist experience. OBJECTIVE: To determine the relationship between the technical difficulty to cannulate Vater's papilla, and time to perform the procedure and fluoroscopy time. METHODS:Patients scheduled for ERCP were divided in two groups depending on the degree of difficulty of the process according to Schutz classification: group A (grades 1-3) and group B (grades 4 and 5). We registered demographic variables, reference diagnosis, endoscopic and radiological diagnoses, degree of difficulty to cannulate Vater's papilla (Freeman scale), duration of procedure, fluoroscopy time and endoscopic complications. RESULTS: 213 patients were included: 101 in group A and 112 in group B. Mean fluoroscopy time was 59.15 seconds in group A and 93.59 seconds in group B (p <0.0001). Mean time to perform the procedure was 13.18 minutes in group A and 20.23 minutes in group B (p <0.0001). Factors related to increased fluoroscopy time were technical difficulty for the CPE according to Schutz (p <0.0001), stent placement (p = 0.021) and hydrostatic dilation (p <0.0001). CONCLUSIONS: The fluoroscopy time increased proportionally to technical difficulty to perform the procedure.