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Keywords:
Gastrointestinal tract, Fluoroscopy, Endoscopy, Cholangiography
Authors:
E. Saukko1, A. Henner2, S.-M. Ahonen2; 1Turku/FI, 2Oulu/FI
DOI:
10.1594/ecr2015/C-0236
Conclusion
The results of this survey demonstrate that the use of radiation in the context of endoscopy has its own specific maneuvers.
In conclusion,
a good radiation protection practice in ERCP requires optimization and recognition of a safety culture in the workplace.
The essential principle for the use of fluoroscopy in endoscopy suite is concept of ALARA,
which stands for “as low as reasonably achievable” [18].
There is a possibility to minimize the exposure to patients and staff during ERCP by using the dose reduction techniques and by appropriate shieldings.
According to the results,
the endoscopy staff was adequately protected by the use of lead aprons,
thyroid collars and lead glasses,
during their work in controlled areas.
Other mobile or portable lead shields were used quite well,
but protection of the patient during ERCP varied significantly between the hospitals.
Modifying the beam by collimate the field size was not commonly in use during ERCP; even it is an easiest way to reduce the amount of radiation.
In addition,
radiographic images were taken during ERCP in most of the hospitals,
but in some circumstances the fluoroscopic images may be sufficient for the documentation of findings.
The use of magnification in ERCP is understandable in some cases,
as the structure of pancreatic and bile ducts are small,
but the images can be enlarged afterward in monitor without an irradiation.
It is obvious that every action to reduce patient dose will have a corresponding impact on occupational doses [1].
Education programme in radiation safety and proper radiation hygiene for healthcare professionals working in ERCP environment will increase awareness of radiation risks and decrease an unnecessary exposure of staff and patients [19].
Some limitations of this study are acknowledged.
A sample of hospitals in this study was relatively small,
but as the hospitals were purposively selected,
the whole country was regionally covered. A questionnaire was targeted at nurses and radiographers participating in ERCP procedures,
but answers of the ERCP endoscopists would have been able to give a more complete picture of the radiation protection practice during ERCP,
as well as a larger sample of hospitals.
Furthermore,
the observation method could provide an intresting and valuable information about the phenomenon under the investigation.