Cumulative Exposure to Ionizing Radiation Among Surgeons During Intraoperative Cholangiography

Intraoperative cholangiography (IOC), even though is an important tool in biliary surgery, it is still a matter of debate when used as a routine procedure, this supported in the surgical and legal safety for the patient and the surgeon. We do not have knowledge of the real expositional risk of the surgeon to ionizing radiation (IR) during the cholangiography procedure, because many surgeons do not use protection and dosimeters, so we cannot determine occupational radiation exposure.

A prospective cohort study was conducted to assess the radiation exposure of a group of surgeons performing laparoscopic cholecystectomy, regardless of the type of surgery (elective or urgent). A descriptive, bivariate analysis was made, with a linear simulation model for prediction. We evaluate the frequency of use of protection-established devices, number of images per surgery, and frequency of IOC. The radiation received was measured by dosimeters at different distances.

A total of 597 IOC were made in the evaluated period. Mean number of IOC per surgeon was five monthly, with an average of two images per surgery. 60% of surgeons did not use protection devices during IOC. The surgeon radiation received was 0.147 millisieverts (mSv) at 1 m, 0.039 mSv at 1.6 m, and 0.007 mSv at 2.5 m.

The volume, quality, and sufficiency of protection, coupled with the distance to the X-ray generator, are the major determinants to define the exposure to IR. We can predict the annual ionizing radiation according to the volume of the accomplished procedures. Although exposure doses are really low and make this a safe procedure, continuous exposure can lead to serious illnesses.