Güitrón-Cantú A, Adalid-Martínez R, Segura-López F K
Departamento de Endoscopia Digestiva, Hospital de Especialidades UMAE No 71, Instituto Mexi- cano del Seguro Social, Torreón, Coahuila.
Rev Gastroenterol Mex. 2011 Jan-Mar;76(1):19-25.
Exposure to radiation during endoscopic retrograde cholangiopancreatography (ERCP) could have adverse effects on the endoscopic team members and patients. There is an inverse relationship between fluoroscopy time and endoscopist experience.
To determine the relationship between the technical difficulty to cannulate Vater's papilla, and time to perform the procedure and fluoroscopy time.
Patients scheduled for ERCP were divided in two groups depending on the degree of difficulty of the process according to Schutz classification: group A (grades 1-3) and group B (grades 4 and 5). We registered demographic variables, reference diagnosis, endoscopic and radiological diagnoses, degree of difficulty to cannulate Vater's papilla (Freeman scale), duration of procedure, fluoroscopy time and endoscopic complications.
213 patients were included: 101 in group A and 112 in group B. Mean fluoroscopy time was 59.15 seconds in group A and 93.59 seconds in group B (p <0.0001). Mean time to perform the procedure was 13.18 minutes in group A and 20.23 minutes in group B (p <0.0001). Factors related to increased fluoroscopy time were technical difficulty for the CPE according to Schutz (p <0.0001), stent placement (p = 0.021) and hydrostatic dilation (p <0.0001).
The fluoroscopy time increased proportionally to technical difficulty to perform the procedure.
在内镜逆行胰胆管造影术（ERCP）期间暴露于辐射可能会对内镜团队成员和患者产生不利影响。透视时间与内镜医师经验之间存在反比关系。
确定插管至十二指肠乳头的技术难度与手术时间及透视时间之间的关系。
根据舒茨分类法，将计划进行ERCP的患者根据手术难度程度分为两组：A组（1 - 3级）和B组（4级和5级）。我们记录了人口统计学变量、参考诊断、内镜和放射学诊断、插管至十二指肠乳头的难度程度（弗里曼量表）、手术持续时间、透视时间和内镜并发症。
纳入213例患者：A组101例，B组112例。A组平均透视时间为59.15秒，B组为93.59秒（p <0.0001）。A组平均手术时间为13.18分钟，B组为20.23分钟（p <0.0001）。与透视时间增加相关的因素有根据舒茨分类法的胰胆管造影术技术难度（p <0.0001）、支架置入（p = 0.021）和水压扩张（p <0.0001）。
透视时间与手术技术难度成比例增加。
