{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2025,10,11]],"date-time":"2025-10-11T00:33:55Z","timestamp":1760142835796,"version":"build-2065373602"},"reference-count":30,"publisher":"MDPI AG","issue":"2","license":[{"start":{"date-parts":[[2024,1,8]],"date-time":"2024-01-08T00:00:00Z","timestamp":1704672000000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":["Diagnostics"],"abstract":"<jats:p>Background: Fluoroscopy must be used cautiously during endoscopic retrograde cholangiopancreatography (ERCP). Radiation exposure data in patients with surgically altered anatomy undergoing enteroscopy-assisted ERCP (EA-ERCP) are scarce. Methods: 34 consecutive EA-ERCP procedures were compared with 68 conventional ERCP (C-ERCP) procedures. Patient and procedure characteristics and radiation data were collected. Results: Surgical reconstructions were gastrojejunostomy, Roux-en-Y hepaticojejunostomy, Roux-en-Y total gastrectomy, Roux-en-Y gastric bypass and Whipple\u2019s duodenopancreatectomy. Procedures were restricted to biliary indications. Mean fluoroscopy time was comparable in both groups (370 \u00b1 30 s EA-ERCP vs. 393 \u00b1 40 s C-ERCP, p = 0.7074), whereas total mean radiation dose was lower in EA-ERCP (83 \u00b1 6 mGy) compared to C-ERCP (110 \u00b1 11 mGy, p = 0.0491) and dose area product (DAP) was higher in EA-ERCP (2216 \u00b1 173 \u00b5Gy*m2) compared to C-ERCP (1600 \u00b1 117 \u00b5Gy*m2, p = 0.0038), as was total procedure time (77 \u00b1 5 min vs. 39 \u00b1 3 min, p &lt; 0.0001). Enteroscope insertion to reach the bile duct during EA-ERCP took 28 \u00b1 4 min, ranging from 4 to 90 min. These results indicate that C-ERCP procedures are generally more complex, needing magnified fluoroscopy, whereas EA-ERCP procedures take more time for enteroscope insertion under wide field fluoroscopic guidance (increased DAP) with less complex ERCP manipulation (lower total radiation dose). Conclusions: Radiation exposure during EA-ERCP in surgically altered anatomy is different as compared to C-ERCP. EA-ERCP takes longer with a higher DAP because of the enteroscope insertion, but with lower total radiation dose because these ERCP procedures are usually less complex.<\/jats:p>","DOI":"10.3390\/diagnostics14020142","type":"journal-article","created":{"date-parts":[[2024,1,8]],"date-time":"2024-01-08T03:49:04Z","timestamp":1704685744000},"page":"142","update-policy":"https:\/\/doi.org\/10.3390\/mdpi_crossmark_policy","source":"Crossref","is-referenced-by-count":0,"title":["Patient Radiation Exposure during Enteroscopy-Assisted Endoscopic Retrograde Cholangiopancreatography in Surgically Altered Anatomy (with Video)"],"prefix":"10.3390","volume":"14","author":[{"ORCID":"https:\/\/orcid.org\/0000-0001-7922-0396","authenticated-orcid":false,"given":"Laurent","family":"Monino","sequence":"first","affiliation":[{"name":"Department of Gastroenterology & Hepatology, Cliniques Universitaires Saint-Luc, 1200 Brussels, Belgium"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-4965-7324","authenticated-orcid":false,"given":"Tom G.","family":"Moreels","sequence":"additional","affiliation":[{"name":"Department of Gastroenterology & Hepatology, Cliniques Universitaires Saint-Luc, 1200 Brussels, Belgium"}],"role":[{"role":"author","vocabulary":"crossref"}]}],"member":"1968","published-online":{"date-parts":[[2024,1,8]]},"reference":[{"key":"ref_1","doi-asserted-by":"crossref","first-page":"752","DOI":"10.1097\/00000658-196805000-00013","article-title":"Endoscopic cannulation of the ampulla of Vater: A preliminary report","volume":"167","author":"McCune","year":"1968","journal-title":"Ann. 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