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The Effect of Fluoroscopy Control on Cannulation Rate and Fluoroscopy Time in Endoscopic Retrograde Cholangiopancreatography Training

대한췌담도학회지 2021년 26권 1호 p.43 ~ 48
Kim Raymond E., Uradomo Lance T., Kim Grace E., Morris John D., Goldberg Eric M., Darwin Peter E.,
소속 상세정보
 ( Kim Raymond E. ) - University of Maryland School of Medicine Division of Gastroenterology and Hepatology
 ( Uradomo Lance T. ) - University of Maryland School of Medicine Division of Gastroenterology and Hepatology
 ( Kim Grace E. ) - University of Maryland Medical Center Department of Internal Medicine
 ( Morris John D. ) - University of Maryland School of Medicine Division of Gastroenterology and Hepatology
 ( Goldberg Eric M. ) - University of Maryland School of Medicine Division of Gastroenterology and Hepatology
 ( Darwin Peter E. ) - University of Maryland School of Medicine Division of Gastroenterology and Hepatology

Abstract


Background/Aim: Endoscopic retrograde cholangiopancreatography (ERCP) training requires varying degrees of staff assistance regarding operation of the fluoroscopy machine via a foot pedal. Efficiency is important to acquire during this training due to radiation risks. In this study, we evaluate the effect of controlling endoscopy and fluoroscopy unit on duct cannulation rates (CRs) and total fluoroscopy time (FT) for fellows in training.

Methods: 204 patients undergoing ERCP were randomized to one of two groups: 1) “Endoscopist Driven” group in which the endoscopist controlled the foot pedal for fluoroscopy, and 2) “Assistant Driven” group in which attending or fellow controlled the foot pedal while the other team member controlled the endoscope. Various measures including selective duct CR and total FT were recorded.

Results: There was no significant difference in mean procedure duration between the two groups (32 minutes vs. 33 minutes, p=0.70). There was also no statistically significant difference in CR (83.7% vs. 77.4%, p=0.25) or FT (3.27 minutes vs. 3.54 minutes, p=0.48).

Conclusions: ERCP is a technically challenging procedure which requires extensive supervision. This study demonstrates that CR and FT are not affected by who controls the fluoroscopy.

키워드

Endoscopic retrograde cholangiography; Education; Instrumentation; Fluoroscopy

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