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CC BY 4.0 · Journal of Digestive Endoscopy 2025; 16(03): 136-142
DOI: 10.1055/s-0045-1811540
Original Article

Fluoroscopy Time Required for Each Step of Interventional Endoscopic Ultrasonography

Masafumi Watanabe 
1   Department of Gastroenterology, Kitasato University School of Medicine, Sagamihara, Kanagawa, Japan
,
Kosuke Okuwaki
1   Department of Gastroenterology, Kitasato University School of Medicine, Sagamihara, Kanagawa, Japan
,
Mitsuhiro Kida
1   Department of Gastroenterology, Kitasato University School of Medicine, Sagamihara, Kanagawa, Japan
,
Hiroshi Imaizumi
1   Department of Gastroenterology, Kitasato University School of Medicine, Sagamihara, Kanagawa, Japan
,
Kai Adachi
1   Department of Gastroenterology, Kitasato University School of Medicine, Sagamihara, Kanagawa, Japan
,
Akihiro Tamaki
1   Department of Gastroenterology, Kitasato University School of Medicine, Sagamihara, Kanagawa, Japan
,
Taro Hanaoka
1   Department of Gastroenterology, Kitasato University School of Medicine, Sagamihara, Kanagawa, Japan
,
Daisuke Ogawa
1   Department of Gastroenterology, Kitasato University School of Medicine, Sagamihara, Kanagawa, Japan
,
Chika Kusano
1   Department of Gastroenterology, Kitasato University School of Medicine, Sagamihara, Kanagawa, Japan
› Institutsangaben
Funding None.
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Abstract

Objectives

Interventional endoscopic ultrasonography (I-EUS) exposes patients to high levels of radiation exposure. However, no research on the fluoroscopy time required for each step of I-EUS has been published. That was the aim of this study.

Materials and Methods

We retrospectively included patients who underwent endoscopic ultrasonography-guided biliary drainage (EUS-BD) and pancreatic duct drainage (EUS-PDD) in our hospital from October 2022 to November 2024. The procedure was categorized into four steps: step 1, transmural puncturing; step 2, guidewire placement; step 3, tract creation; and step 4, stent placement. We measured the fluoroscopy time required for each step via the fluoroscopic videos.

Statistical Analysis

Continuous variables were described using medians and the first to third quartiles (Q1–Q3).

Results

The study included 36 participants (EUS-BD: 33, EUS-PDD: 3). The median [Q1–Q3] fluoroscopy times required for steps 1 to 4 were 120 [96–152], 175 [123–449], 194 [101–303], and 171 [90–208] seconds, respectively, for EUS-BD and 169 [119–195], 302 [234–529], 435 [430–477], and 233 [170–266] seconds, respectively, for EUS-PDD.

Conclusion

In I-EUS, the fluoroscopy time required for step 3, tract creation, was the longest. The technique needs to be improved, new devices developed, and clear communication be established among the operating team to prevent unnecessary fluoroscopy.

Keywords

fluoroscopy - interventional endoscopic ultrasonography - radiation exposure

Data Availability Statement

The data that support the findings of this study are available from the corresponding author upon reasonable request.


Authors' Contributions

M.W. designed the study and drafted the initial manuscript. K.O., M.K., and H.I. contributed to data analysis and interpretation and assisted in manuscript preparation. All other authors participated in data collection and interpretation and critically reviewed the manuscript. All authors approved the final version and agreed to be accountable for all aspects of the work, ensuring that any questions regarding accuracy or integrity are properly investigated and resolved.


Ethical Approval

This study was approved by our institutional review board (approval number: KMEO B24–161) and conducted according to the tenets of the Declaration of Helsinki of 1975, as revised in 2000.


Patients' Consent

Written informed consent for the procedure was obtained from all patients. For publication of this study, authors used the opt-out method to gain patient consent. Specifically, they posted an announcement on our institution's Web site to inform patients about the study, and those who opted out were excluded from the study.




Publikationsverlauf

Artikel online veröffentlicht:
22. August 2025

© 2025. The Author(s). This is an open access article published by Thieme under the terms of the Creative Commons Attribution License, permitting unrestricted use, distribution, and reproduction so long as the original work is properly cited. (https://creativecommons.org/licenses/by/4.0/)

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