Location of endoscopic retrograde cholangiopancreatography impacts fluoroscopy time: a multi-institutional retrospective study at tertiary academic centers.

BACKGROUND

Endoscopic retrograde cholangiopancreatography (ERCP) is important in the management of pancreatobiliary diseases and requires fluoroscopy resulting in radiation exposure to those involved. ERCP is performed in different hospital settings such as the endoscopy unit (EU), radiology suite (RS), and operating room (OR) depending on numerous factors. Our study examines the differences in duration of fluoroscopy time (FT) as a surrogate for radiation dosages between multiple unique settings.

METHODS

A retrospective cohort analysis at multiple tertiary academic centers was performed on 3251 ERCPs performed between April 2015 to November 2021. FT was compared between multiple locations, between different fluoroscopy device operators, and between normal working hours versus after hours.

RESULTS

Of the 3228 included patients, 54.8% (n = 1768) patients had an exam in the EU, 37.9% (n = 1223) RS or 7.3% (n = 237) or OR respectively. The average FT in the EU, RS, and OR was 6.0 min, 3.5 min, and 4.1 min respectively. The average FT of the EU was significantly more than the RS, OR, and RS and OR together. The average FT of the cases in the OR was significantly less than cases done outside of the OR (5.0 min). FT during working hours (5.0 min) was significantly longer than FT outside of working hours (3.3 min).

CONCLUSIONS

FT in the EU was longer than in the OR and RS. Locations in which ERCPs were performed by the endoscopist had a longer average FT than those with technician-controlled fluoroscopy.