내시경 역행성 췌담관조영술에서 자체 제작된 납 차폐막의 방사선 차단효과

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.