Naidu L S, Singhal S, Preece D E, Vohrah A, Loft D E
Department of Gastroenterology, University Hospitals Coventry and Warwickshire NHS Trust, UK.
Postgrad Med J. 2005 Oct;81(960):660-2. doi: 10.1136/pgmj.2004.031526.
Endoscopic retrograde cholangiopancreatography (ERCP) relies on the use of ionising radiation but risks to operator and patient associated with radiation exposure are unclear. The aim of this prospective study was to estimate the radiation dose received by personnel performing fluoroscopic endoscopic procedures, mainly ERCP.
Consecutive procedures over a two month period were included. The use of thermoluminescent dosimeters to measure radiation exposure to the abdomen, thyroid gland, and hands of the operator permitted an estimation of the annual whole body effective dose equivalent.
During the study period 66 procedures (61 ERCP) were performed and the estimated annual whole body effective dose equivalent received by consultant operators ranged between 3.35 and 5.87 mSv. These values are similar to those received by patients undergoing barium studies and equate to an estimated additional lifetime fatal cancer risk between 1 in 7000 and 1 in 3500. While within legal safety limits for radiation exposure to personnel, these doses are higher than values deemed acceptable for the general public.
It is suggested that personnel as well as patients may be exposed to significant values of radiation during ERCP. The study emphasises the need to carefully assess the indication for, and to use measures that minimise radiation exposure during any fluoroscopic procedure.
内镜逆行胰胆管造影术（ERCP）依赖于电离辐射，但与辐射暴露相关的操作者和患者风险尚不清楚。这项前瞻性研究的目的是估计进行荧光内镜检查（主要是ERCP）的人员所接受的辐射剂量。
纳入连续两个月期间的手术。使用热释光剂量计测量操作者腹部、甲状腺和手部的辐射暴露，从而估算年度全身有效剂量当量。
在研究期间共进行了66例手术（61例ERCP），顾问操作者所接受的估计年度全身有效剂量当量在3.35至5.87毫希沃特之间。这些数值与接受钡剂检查的患者所接受的数值相似，相当于估计的额外终身致命癌症风险在七千分之一至三千五百分之一之间。虽然这些剂量在人员辐射暴露的法定安全限度内，但高于一般公众可接受的数值。
提示在ERCP期间，人员以及患者可能会暴露于显著的辐射剂量。该研究强调在任何荧光检查过程中，需要仔细评估适应证并采取措施尽量减少辐射暴露。
