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Fluoroscopy is used frequently during endoscopic procedures, such as endoscopic retrograde cholangiopancreatography (ERCP). However, exposure to radiation is an important health concern, primarily because of the potential increase in the lifetime risk of malignancy. This consideration is important for patients and staff exposed to radiation during ERCP. Thus, an understanding of how radiation doses are measured during ERCP and the potential risks of this radiation is important. Additionally, staff must be educated about methods used to minimize the radiation dose, such as the use of different imaging techniques, the general principles of fluoroscopy, and advances in hardware and software. The use of personal protective equipment is also essential to minimize occupational exposure. However, no comprehensive ERCP guideline on the use of X-ray systems in clinical settings or on radiation protection for operators has been established. This review focuses on the properties of fluoroscopy systems and methods of radiation protection for physicians and assistants participating in ERCP.
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http://www.ncbi.nlm.nih.gov/pmc/articles/PMC9666259 | PMC |
http://dx.doi.org/10.3904/kjim.2022.093 | DOI Listing |
Dig Endosc
September 2025
Gastrointestinal Endoscopy Unit, Division of Gastroenterology, Hospital das Clínicas of the Faculty of Medicine of the University of São Paulo - HC/FMUSP, São Paulo, Brazil.
Background: Difficult biliary cannulation is a key challenge in endoscopic retrograde cholangiopancreatography and a major risk factor for post-ERCP pancreatitis. When the pancreatic duct is unintentionally accessed, double guidewire (DGW) is the primary rescue strategy, while transpancreatic sphincterotomy (TPS) is an alternative. Previous evidence suggests that TPS may achieve higher cannulation success and lower PEP rates compared to DGW, though direct comparative data remain limited.
View Article and Find Full Text PDFArch Esp Urol
August 2025
Department of Urology, The Affiliated Hospital of Qingdao University, 266000 Qingdao, Shandong, China.
Background: Ureteroscopic lithotripsy using a semi-rigid ureteroscope is the standard treatment for urinary stones. Doxazosin-an alpha-1 adrenergic receptor blocker-relaxes ureteral smooth muscles, reducing peristalsis and contraction frequency. This study aimed to evaluate the efficacy and safety of adjunctive doxazosin before semi-rigid ureteroscopy and retrograde intrarenal surgery (RIRS) for urinary stones.
View Article and Find Full Text PDFArch Esp Urol
August 2025
Department of Urology, Kartal Dr. Lutfi Kirdar City Hospital, 34865 Istanbul, Turkey.
Background: Percutaneous nephrolithotomy (PNL) is a gold-standard procedure for managing complex kidney stones. It is traditionally performed in the prone position. Supine PNL offers benefits, such as enhanced ergonomics and simultaneous retrograde surgery.
View Article and Find Full Text PDFBackground And Aims: Whereas the value of endoscopic retrograde cholangiopancreatography (ERCP) training in clinical practice is well known, the impact on stress markers and performance in a virtual reality (VR) simulator is not. The primary aim of the study was to see how the number of clinical ERCPs performed during a 1-year period influenced VR-ERCP performance. A secondary aim was to compare differences in salivary stress marker levels, between the first and final simulator attempts.
View Article and Find Full Text PDFCureus
August 2025
Liver Cancer Department, Binh Dan Hospital, Ho Chi Minh, VNM.
Duodenal perforation is a rare but harmful complication of endoscopic retrograde cholangiopancreatography (ERCP). Early diagnosis and appropriate management are critical to reduce morbidity and mortality. Four patients, aged 36 to 56 years, underwent ERCP for biliary obstruction due to choledocholithiasis or postoperative biliary stricture.
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