CC BY-NC-ND 4.0 · Endosc Int Open 2018; 06(08): E969-E974
DOI: 10.1055/a-0599-5917
Original article
Owner and Copyright © Georg Thieme Verlag KG 2018

The difference in ocular lens equivalent dose to ERCP personnel between prone and left lateral decubitus positions: a prospective randomized study

Phonthep Angsuwatcharakon
1  Division of Gastroenterology, Department of Medicine, Chulalongkorn University and King Chulalongkorn Memorial Hospital, Bangkok, Thailand
2  Department of Anatomy, Chulalongkorn University and King Chulalongkorn Memorial Hospital, Bangkok, Thailand
,
Worawarut Janjeurmat
1  Division of Gastroenterology, Department of Medicine, Chulalongkorn University and King Chulalongkorn Memorial Hospital, Bangkok, Thailand
,
Anchali Krisanachinda
3  Division of Nuclear Medicine, Department of Radiology, Faculty of Medicine Chulalongkorn University and King Chulalongkorn Memorial Hospital, Bangkok, Thailand
,
Wiriyaporn Ridtitid
1  Division of Gastroenterology, Department of Medicine, Chulalongkorn University and King Chulalongkorn Memorial Hospital, Bangkok, Thailand
,
Pradermchai Kongkam
1  Division of Gastroenterology, Department of Medicine, Chulalongkorn University and King Chulalongkorn Memorial Hospital, Bangkok, Thailand
,
Rungsun Rerknimitr
1  Division of Gastroenterology, Department of Medicine, Chulalongkorn University and King Chulalongkorn Memorial Hospital, Bangkok, Thailand
› Author Affiliations
TRIAL REGISTRATION: Interventional (Clinical Trial) NCT02791659 at clinicaltrials.gov
Further Information

Publication History

submitted 25 August 2017

accepted after revision 05 March 2018

Publication Date:
01 August 2018 (online)

Abstract

Background and study aims Endoscopic retrograde cholangiopancreatography (ERCP) is commonly performed in a prone or left lateral decubitus (LLD) position. The ocular lens equivalent doses between the two positions may be different because in the LLD position the tube voltage will automatically increase to maintain the image quality, and the increased distance between the image intensifier and the X-ray tube may result in more scattered radiation. We aimed to compare the ocular lens equivalent doses of ERCP personnel between the two different positions.

Patients and methods Fifty-five patients with ERCP indications were randomized to either prone or LLD positions. One patient in an LLD position was excluded due to technical reasons. Indications for ERCP, patients’ vertical thicknesses, fluoroscopy parameters, patients’ skin dose rates, and the ocular-lens equivalent doses of ERCP personnel were compared.

Results Baseline characteristics were no different except for vertical thickness, which was significantly higher in the LLD group. The ocular lens equivalent doses (prone vs. LLD) of the primary endoscopist (19.2 vs. 30.7 µSv, P = 0.035), and the nurse anesthetist (17.3 vs. 42.2 µSv, P = 0.002) were significantly lower in the prone group than in the LLD group. The calculated annual number of procedures not to exceed the exposure allowance in prone and LLD positions were 1,042 and 651 procedures for the primary endoscopist and 1,157 and 473 procedures for the nurse anesthetist, respectively.

Conclusions Ocular-radiation exposure to ERCP personnel was one-third lower in the prone than in LLD position. Therefore, more annual ERCPs could be performed by the personnel.