Radiation exposure dose of fluoroscopy-guided gastrointestinal procedures: A single-center retrospective study

Background and study aims Fluoroscopy-guided gastrointestinal procedures (FGPs) are increasingly common. However, the radiation exposure (RE) to patients undergoing FGPs is still unclear. We examined the actual RE of FGPs. Patients and methods This retrospective, single-center cohort study included consecutive FGPs, including endoscopic retrograde cholangiopancreatography (ERCP), interventional endoscopic ultrasound (EUS), enteral stenting, balloon-assisted enteroscopy, tube placement, endoscopic injection sclerotherapy (EIS), esophageal balloon dilatation and repositioning for sigmoid volvulus, from September 2012 to June 2019. We measured the air kerma (AK, mGy), dose area product (DAP, Gycm(2)), and fluoroscopy time (FT, min) for each procedure. Results In total, 3831 patients were enrolled. Overall, 2778 ERCPs were performed. The median AK, DAP, and FT were as follows: ERCP: 109mGy, 13.3Gycm(2) and 10.0min; self-expandable enteral stenting (SEMS): 62mGy, 12.4 Gycm(2) and 10.4min; tube placement: 40mGy, 13.8 Gycm(2) and 11.1 min; balloon- assisted enteroscopy: 43mGy, 22.4Gycm(2) and 18.2min; EUS cyst drainage (EUS-CD): 96mGy, 18.3Gycm(2) and 10.4min; EIS: 36mGy, 8.1 Gycm(2) and 4.4 min; esophageal balloon dilatation: 9 mGy, 2.2 Gycm(2) and 1.8 min; and repositioning for sigmoid volvulus: 7mGy, 4.7Gycm(2) and 1.6 min. Conclusion This large series reporting actual RE doses of various FGPs could serve as a reference for future prospective studies.