Factors Affecting Radiation Exposure to Patients During ERCP

B. Ravi Shankar, B. Shruti Sagar, Viswanath Reddy Donapati, Rakesh Kumar Adi, G. Srinivas Rao, Kiran Kumar Jogu, Shiva Nagilla

Abstract: Introduction: Endoscopic retrograde cholangiopancreatography (ERCP) is a common technique performed worldwide for the indications of cholangitis, biliary tract pathology and pancreatic duct disease. Fluoroscopy is a requisite during ERCP which involves varied doses of radiation exposure to both patient & the team involved. Objective: This study aims to measure the radiation exposure during ERCP and to identify patient and procedural factors associated with increased radiation exposure during ERCP. Materials & Methods: In this retrospective, single-center study of 375 patients who underwent ERCP between January to October 2023, we analyzed the influence of indication of ERCP and presence of native papilla on the following radiation exposure parameters - Cumulative radiation dose (mGy), dose area parameter (Gy-cm²), total fluoroscopy time and number of fluoroscopy shots. Using SPSS version 24, statistical tests were performed. Results: The major indication for ERCP in our study was choledocholithiasis (55 %). The mean cumulative radiation dose was 44.54 ±2.35 mGy, mean DAP 12.49 ±0.77, average number of fluoroscopy shots 26.46±1.04 and mean fluoroscopy time was 6.58 ±4.06 minutes. Various indications like choledocholithiasis, benign biliary stricture, malignant biliary stricture and pancreatic duct stones were analyzed. There was a significant difference between ERCP quality indicators and indications. Among the indications, Benign biliary stricture had the highest cumulative radiation dose (60.94 ± 5.99 mGy), DAP (17.92 ± 2.61 Gy-cm²) and number of fluoro shots (32.51 ± 2.82). Presence of prior sphincterotomy/native papilla did not significantly influence radiation parameters recorded in the study. Conclusion: The amount of radiation that a patient was exposed to was influenced by the nature of the indication, disease behavior and complexity of the ERCP procedure. Radiation dose parameters such as dose area parameters (DAP), median cumulative dose exposure and total fluoroscopy time can be used as ERCP quality indicators.

Keywords: Choledocholitiasis, Pancreatitis, Biliary stricture, Cholangitis, Fluoroscopy

How to Cite?: B. Ravi Shankar, B. Shruti Sagar, Viswanath Reddy Donapati, Rakesh Kumar Adi, G. Srinivas Rao, Kiran Kumar Jogu, Shiva Nagilla, "Factors Affecting Radiation Exposure to Patients During ERCP", Volume 14 Issue 11, November 2025, International Journal of Science and Research (IJSR), Pages: 600-605, https://www.ijsr.net/getabstract.php?paperid=SR251107131259, DOI: https://dx.doi.org/10.21275/SR251107131259