Boix Jaume, Lorenzo-Zúñiga Vicente
Jaume Boix, Vicente Lorenzo-Zúñiga, Endoscopy Unit, Department of Gastroenterology, Hospital Universitari Germans Trias i Pujol, Badalona, Barcelona 08916, Spain.
World J Gastrointest Endosc. 2011 Jul 16;3(7):140-4. doi: 10.4253/wjge.v3.i7.140.
Endoscopic retrograde cholangiopancreatography (ERCP) is an important tool for the diagnosis and treatment of the hepatobiliary system. The use of fluoroscopy to aid ERCP places both the patient and the endoscopy staff at risk of radiation-induced injury. Radiation dose to patients during ERCP depends on many factors, and the endoscopist cannot control some variables, such as patient size, procedure type, or fluoroscopic equipment used. Previous reports have demonstrated a linear relationship between radiation dose and fluoroscopy duration. When fluoroscopy is used to assist ERCP, the shortest fluoroscopy time possible is recommended. Pulsed fluoroscopy and monitoring the length of fluoroscopy have been suggested for an overall reduction in both radiation exposure and fluoroscopy times. Fluoroscopy time is shorter when ERCP is performed by an endoscopist who has many years experience of performing ERCP and carried out a large number of ERCPs in the preceding year. In general, radiation exposure is greater during therapeutic ERCP than during diagnostic ERCP. Factors associated with prolonged fluoroscopy have been delineated recently, but these have not been validated.
内镜逆行胰胆管造影术（ERCP）是诊断和治疗肝胆系统的一项重要工具。使用荧光透视辅助ERCP会使患者和内镜工作人员都面临辐射所致损伤的风险。ERCP期间患者所接受的辐射剂量取决于多种因素，并且内镜医师无法控制一些变量，如患者体型、手术类型或所使用的荧光透视设备。既往报告显示辐射剂量与荧光透视持续时间之间呈线性关系。当使用荧光透视辅助ERCP时，建议尽可能缩短荧光透视时间。有人提出采用脉冲荧光透视和监测荧光透视时长，以全面减少辐射暴露和荧光透视时间。由具有多年ERCP操作经验且上一年实施大量ERCP手术的内镜医师进行ERCP时，荧光透视时间较短。一般而言，治疗性ERCP期间的辐射暴露比诊断性ERCP期间更大。最近已明确了与荧光透视时间延长相关的因素，但这些因素尚未得到验证。
