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A simple ergonomic measure reduces fluoroscopy time during ERCP: A multivariate analysis.

Fahd Jowhari1, Wilma M Hopman2, Lawrence Hookey1

  • 1Gastrointestinal Diseases Research Unit, Kingston General Hospital, Queen's University, Kingston, Ontario, Canada.

Endoscopy International Open
|March 17, 2017
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Summary
This summary is machine-generated.

Reducing fluoroscopy screen distance during endoscopic retrograde cholangiopancreatography (ERCP) significantly lowers radiation exposure. This ergonomic change, along with endoscopist volume, impacts fluoroscopy time (FT) and patient safety.

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Area of Science:

  • Gastroenterology
  • Medical Imaging
  • Radiation Safety

Background:

  • Endoscopic retrograde cholangiopancreatography (ERCP) involves radiation exposure for patients and staff.
  • Fluoroscopy time (FT) is a key determinant of radiation dose during ERCP.
  • ERCP suite design modifications may influence FT and procedural ergonomics.

Purpose of the Study:

  • To investigate the impact of ERCP suite design modifications on fluoroscopy time (FT).
  • To identify and validate clinical, procedural, and ergonomic factors affecting FT during ERCP.
  • To provide insights for predicting and mitigating prolonged fluoroscopic durations.

Main Methods:

  • Retrospective analysis of 299 ERCP procedures performed by 4 endoscopists over 18 months.
  • Inclusion of inpatients and outpatients undergoing ERCP for various indications.
  • Multivariate analysis using clinical, procedural, and ergonomic factors to predict FT.

Main Results:

  • Decreasing the distance between endoscopy and fluoroscopy screens significantly reduced FT (-1.4 min, P=0.026).
  • Factors increasing FT included prior ERCP (+1.4 min, P=0.031) and procedure difficulty (+4.2 min per level, P<0.001).
  • High-volume endoscopists demonstrated reduced FT compared to low-volume endoscopists (-1.82 min, P=0.015).

Conclusions:

  • The study identified key factors influencing ERCP fluoroscopy time.
  • Reducing screen proximity in the ERCP suite is a novel method to decrease FT and radiation exposure.
  • Ergonomic improvements in suite design can enhance patient and staff safety during ERCP.