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Related Concept Videos

Endoscopic Procedures V: ERCP01:26

Endoscopic Procedures V: ERCP

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Endoscopic Retrograde Cholangiopancreatography (ERCP) is a diagnostic procedure that combines endoscopy and fluoroscopy to diagnose and treat conditions related to the bile ducts, pancreatic ducts, and gallbladder. This procedure is beneficial for identifying and addressing blockages, gallstones, strictures, and tumors within the biliary or pancreatic systems. ERCP is both diagnostic and therapeutic, offering the ability to visualize and treat identified problems in one session.
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Radiation-based indicators for ERCP quality evaluation.

Grecia C Celis-Valenzuela1, Raúl A Jiménez-Castillo1, Luis A González-Torres1

  • 1Gastroenterology and Endoscopy Service, "Dr. José E. González" University Hospital, Universidad Autónoma de Nuevo León, Monterrey, NL, Mexico.

Gastroenterologia Y Hepatologia
|May 4, 2026
PubMed
Summary

Fluoroscopy time (FT) and radiation dose (RD) can serve as quality indicators for endoscopic retrograde cholangiopancreatography (ERCP). These metrics help identify low-risk ERCP procedures, improving patient safety and procedural standards.

Keywords:
CPRE (colangiopancreatografía retrógrada endoscópica)Dosis de fluoroscopiaERCP (endoscopic retrograde cholangiopancreatography)Fluoroscopy doseFluoroscopy timeIndicador de calidadQuality indicatorTiempo de fluoroscopia

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Area of Science:

  • Gastroenterology
  • Medical Imaging
  • Quality Improvement

Background:

  • Endoscopic retrograde cholangiopancreatography (ERCP) radiation exposure lacks established quality indicators.
  • Validated cut-off values for fluoroscopy time (FT) and radiation dose (RD) are needed to assess ERCP safety.

Purpose of the Study:

  • To establish validated cut-off values for FT and RD as surrogate quality indicators for ERCP.
  • To identify low-risk ERCP procedures based on radiation exposure metrics.

Main Methods:

  • Retrospective analysis of 1,328 ERCP procedures.
  • Development of a composite outcome including ERCP complications and ASGE grade 3 procedures.
  • Receiver Operating Characteristic (ROC) curve analysis to determine optimal FT and RD thresholds.

Main Results:

  • Optimal FT cut-off identified at >4.32 minutes (AUC 0.672) and RD at >32.5 mGy (AUC 0.683).
  • Negative Predictive Values for these thresholds were 89.2% for FT and 88.7% for RD.
  • Reproducibility of FT and RD as quality indicators was demonstrated.

Conclusions:

  • FT and RD are reproducible quality indicators for ERCP.
  • These metrics can effectively identify low-risk ERCP procedures.
  • Proposed FT and RD thresholds can serve as new academic and standardized objectives for ERCP quality assessment.