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A PROSPECTIVE STUDY OF FLUOROSCOPY TIME AT ERCP
M McLoughlin, E Kim, E Lam, M Byrne, J Amar, J Telford, R Enns
Division of Gastroenterology, University of British Columbia, Vancouver, British Columbia
Aims: To determine from a prospective data collection if there were specific patient or physician related factors that are associated with fluoroscopy duration.
Methods: We performed a prospective analysis of 432 consecutive ERCPs at 2 tertiary referral hospitals over a 9 month period. Information including fluoroscopy time, patient characteristics, ERCP indication, the interventions performed, endoscopist, presence or otherwise of a trainee and diagnosis were recorded at the time of the procedure.
Results: 40 records were excluded due to incomplete data collection. Therefore, 392 procedures were suitable for analysis. The mean fluoroscopy time was 6.75 minutes. The mean fluoroscopy times (in minutes) for different diagnoses were as follows: CBD stones (n=127) 8.3, biliary strictures (n=94) 7.3, other diagnoses (n=73) 6.1. When no pathology was seen (n=98) the mean fluoroscopy time was shorter at 3.56 minutes (3.05-4.07). If a patient had a previous sphincterotomy (n=140) the mean time was 5.99 minutes, compared to 6.24 minutes when no previous sphinterotomy had been performed (n=252). When a Fellow was involved in the ERCP procedure (n=320) the mean fluoroscopy time was 6.62 minutes, compared with 4.44 minutes when a trainee was not present (n=72). The results of a multivariate analysis are pending.
Conclusions: In this prospective preliminary analysis of ERCP fluoroscopy time, the diagnoses of CBD stones and biliary strictures are associated with longer fluoroscopy times. The involvement of a GI Fellow in the procedure also appears to increase the fluoroscopy time. The factors associated with, and implications of, longer fluoroscopy time warrant further investigation.