Background and Aims

ERCP has the risk of exposure to ionizing radiation. Performers may unconsciously increase fluoroscopy time (FT) because of a lack of radiation protection awareness. This study investigates whether a flashing warning light adopted as a behavioral intervention for performers reduces FT and radiation exposure during ERCP.

Methods

We conducted a prospective randomized trial of 200 therapeutic ERCPs. A flashing warning light was placed on top of the endoscopy monitor. Cases were consecutively enrolled and randomly assigned to 2 groups in a 1:1 ratio. In the warning light group, the light was on when the fluoroscopy foot pedal was depressed; in the control group, the light was off. Fluoroscopy and procedure-related data were recorded.

Results

The median FT and dose-area product (DAP) for the warning light group versus the control group were 142.5 seconds versus 175.0 seconds (P = .045) and 856.8 μGy∙m² versus 1054.4 μGy∙m² (P = .043). In a multivariable analysis, the use of the warning light was found to reduce FT by 15.4% (–27.0 seconds; P = .042). DAP reduction because of the decreased FT was 15.2% (160.3 μGy∙m²). The reduction in patient effective dose per case was .42 mSv, equivalent to 21 chest radiographs. No adverse events or interference with the procedures because of the warning light were noted.

Conclusions

The use of a flashing warning light is a feasible way to reduce FT and radiation exposure during ERCP. (Clinical trial registration number: ChiCTR-IPR-14005349.)

中文翻译：

---

一项单中心的前瞻性前瞻性随机试验性试验，用于评估闪烁的警示灯对减少ERCP期间的荧光检查时间和减少辐射暴露的短期影响

背景和目标

ERCP有暴露于电离辐射的风险。表演者可能由于缺乏辐射防护意识而无意识地增加了透视时间（FT）。这项研究调查了闪烁的警示灯是否可以作为对表演者的行为干预，以减少ERCP期间的FT和辐射暴露。

方法

我们进行了200例治疗性ERCP的前瞻性随机试验。闪烁的警告灯放在内窥镜监视器的顶部。病例被连续纳入，并以1：1的比例随机分为2组。在警告灯组中，踩下荧光检查脚踏板时该灯点亮；在对照组中，灯熄灭。记录透视和与程序相关的数据。

结果

警告灯组与对照组的中值FT和剂量面积积（DAP）分别为142.5秒和175.0秒（P  = .045）和856.8μGy ∙m ²与1054.4μGy∙m ²（P  = .043） 。在多变量分析中，发现使用警告灯可将FT降低15.4％（– 27.0秒；P  = .042）。由于FT降低，DAP降低了15.2％（160.3μGy∙m ²）。每例患者的有效剂量减少了0.42 mSv，相当于21幅胸片。没有发现由于警告灯引起的不良事件或对程序的干扰。

结论

使用闪烁的警告灯是减少ERCP期间FT和辐射暴露的可行方法。（临床试验注册号：ChiCTR-IPR-14005349。）