Korean J Gastroenterol.  2011 Jan;57(1):28-33. 10.4166/kjg.2011.57.1.28.

Efficacy of a Self-designed Protective Lead Shield in Reduction of Radiation Exposure Dose During Endoscopic Retrograde Cholangiopancreatography

• Kim YJ
• Cho KB
• Kim ES
• Park KS
• Jang BK
• Chung WJ
• Hwang JS

• KMID: 991465
• DOI: http://doi.org/10.4166/kjg.2011.57.1.28

Abstract

BACKGROUND/AIMS
The increasing use of diagnostic and therapeutic endoscopic retrograde cholangiopancreatography (ERCP) calls for greater consideration of radiation exposure risk to endoscopists and assistants, and emphasizes the proper system of radiation protection. This study was designed to assess the effect of a newly developed, self-designed, protective lead shield.
METHODS
A curtain-shaped protective shield composed of seven movable lead plates was developed, each with the following dimensions: depth, 0.1 cm; width, 15 cm; length, 70 cm. The curtain-shaped protective shield was designed to be located between the patient and the endoscopist. Twenty-nine patients (11 men and 18 women) undergoing ERCP between January 2010 and March 2010 were selected for this study. The dose of radiation exposure was recorded with or without the protective lead shield at the level of the head, chest, and pelvis. The measurement was made at 50 cm and 150 cm from the radiation source.
RESULTS
The mean patient age was 64 years. The mean patient height and weight was 161.7+/-6.9 cm and 58.9+/-9.9 kg, respectively. The mean body mass index (BMI) was 22.5+/-3.0 kg/m2. Endoscopists received 1522.2+/-537.0 mR/hr without the protective lead shield. At the same distance, radiation exposure was significantly reduced to 68.8+/-88.0 mR/hr with the protective lead shield (p-value<0.0001). The radiation exposure to endoscopists and assistants was significantly reduced by the use of a protective lead shield (p value<0.0001). The amount of radiation exposure during ERCP was related to the patient's BMI (r=0.749, p=0.001).
CONCLUSIONS
This self-designed, protective lead shield is effective in protecting endoscopists and assistants from radiation exposure.

Keyword

Radiation; Protective shield; ERCP

MeSH Terms

Adult
Aged
Body Mass Index
Cholangiopancreatography, Endoscopic Retrograde/*adverse effects
Common Bile Duct Diseases/diagnosis/therapy
Female
Humans
Male
Middle Aged
Radiation Dosage
Radiation Injuries/*prevention & control
*Radiation Monitoring/methods
Radiation Protection/*methods

Figure

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  Fig. 1. Self-designed, protective lead shield. (A) Self-designed, protective lead shield consists of vertically-flexible, disposable, radiation-protective drapes placed directly on the patient in the sterile field. (B) The lead shield does not interfere with the performance of endoscopic procedures, or with fluoroscopic or video endoscopic visualization.

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  Fig. 2. Relation graph between BMI and radiation exposure. The amount of radiation exposure during ERCP was strongly related to the patient's BMI. BMI, body mass index; ERCP, endoscopic retrograde cholangio pancreatography.

Reference

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