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How safe is ERCP to the endoscopist?
R V Cohen1, M A Aldred, W S Paes
1Division of Surgical Endoscopy, Health Physics, Occupational Medicine and Dosimetry Laboratory, University of São Paulo, São Paulo, Brazil.
Surgical Endoscopy
|June 1, 1997
Summary
Physicians performing endoscopic retrograde cholangiopancreatography (ERCP) must use protective gear to minimize radiation exposure. Lead aprons and thyroid shields are crucial for safe practice, limiting monthly procedures to prevent health risks.
Area of Science:
- Medical Imaging
- Endoscopic Procedures
- Radiation Safety
Background:
- Endoscopic retrograde cholangiopancreatography (ERCP) use has increased, often involving fluoroscopy and potential chronic X-ray exposure.
- Radiation exposure can lead to serious health issues, including cancers and cataracts, significantly impacting quality of life.
Purpose of the Study:
- To assess radiation dose equivalents for physicians during ERCP procedures.
- To compare measured doses against established radiation protection standards.
Main Methods:
- Simulated ERCP examinations were conducted using an anthropomorphic phantom.
- Dosimeters were placed on the forehead, neck, torso, and lower abdomen (with and without a lead apron).
Main Results:
- Lead aprons are essential; without one, less than one ERCP per month is advised.
- With a lead apron, up to 23 ERCPs per month are permissible.
- Using thyroid protection allows for 19 exams/month, while lead glasses permit only seven ERCPs monthly due to eye hazards.
Conclusions:
- A 0.5 mm lead apron is fundamental for safe ERCP practice.
- Thyroid and eye protection are critical to minimize radiation-induced health risks.
- Adherence to radiation safety guidelines ensures physician well-being during interventional endoscopy.