Table 4.
Dose indices and fluoroscopy times of the ERCP procedures performed at different centers for non-PSC and PSC indications according to HOUSE procedural complexity level grading.
| Center and Complexity Level (ERCPs Without PSC/with PSC) | Fluoroscopy Time, min | KAP, Gy·cm2 | Ka,r, mGy | Number of Exposures | ||||
|---|---|---|---|---|---|---|---|---|
| w/o PSC | PSC | w/o PSC | PSC | w/o PSC | PSC | w/o PSC | PSC | |
| Center 1 (1212/288) | 0.7 (0.4–1.6) | 4.8 (2.7–7.6) | 0.9 (0.4–1.9) | 3.0 (2.0–5.5) | 3.7 (1.6–9.1) | 19.9 (12.5–39.0) | 2 (0–3) | 5 (5–6) |
| Level 1 (639/1) | 0.6 (0.3–1.2) | 4.2 (4.2–4.2) | 0.8 (0.4–1.7) | 3.3 (3.3–3.3) | 3.0 (1.3–6.9) | 20.5 (20.5–20.5) | 1 (0–3) | 5 (5–5) |
| Level 2 (322/281) | 1.1 (0.5–2.1) | 4.8 (2.9–7.6) | 1.1 (0.5–2.2) | 3.0 (2.0–5.6) | 4.8 (2.1–10.5) | 20.5 (13.0–39.4) | 2 (1–3) | 5 (5–6) |
| Level 3 (251/6) | 1.0 (0.4–2.0) | 1.3 (0.8–4.2) | 0.9 (0.4–2.2) | 1.1 (0.5–1.9) | 4.4 (1.8–10.7) | 6.0 (3.0–9.7) | 2 (0–3) | 4 (2–4) |
| p-value (complexity levels) | <0.001 | 0.085 | 0.003 | 0.006 | <0.001 | 0.003 | <0.001 | 0.049 |
| p-value (PSC vs. w/o PSC) | <0.001 | <0.001 | <0.001 | <0.001 | ||||
| Center 2 (687/9) | 5.5 (3.5–9.4) | 4.5 (3.9–6.9) | 64.4 (38.1–106.7) | 49.6 (32.5–83.0) | 207.1 (120.1–350.7) | 264.3 (118.7–461.4) | 40 (29–52) | 38 (36–59) |
| Level 1 (543/0) | 5.0 (3.1–8.3) | – | 60.1 (35.5–102.9) | – | 190.8 (111.2–315.8) | – | 38 (28–49) | – |
| Level 2 (72/8) | 9.0 (5.2–13.3) | 5.3 (3.5–8.6) | 79.0 (55.5–120.2) | 58.4 (29.8–103.1) | 277.3 (168.4–400.8) | 258.3 (115.9–510.1) | 42 (29–59) | 38 (36–62) |
| Level 3 (72/1) | 8.2 (5.7–13.2) | 4.0 (4.0–4.0) | 83.4 (49.4–134.5) | 48.7 (48.7–48.7) | 254.8 (157.6–449.0) | 264.3 (264.3–264.3) | 52 (39–71) | 43 (43–43) |
| p-value (complexity levels) | <0.001 | 0.889 | <0.001 | 0.889 | <0.001 | 1.000 | <0.001 | 1.000 |
| p-value (PSC vs. w/o PSC | 0.771 | 0.430 | 0.456 | 0.532 | ||||
| Center 3 (167/4) | 1.4 (0.8–2.3) | 2.9 (2.0–4.0) | 1.2 (0.7–2.0) | 1.3 (1.2–2.2) | 9.7 (5.7–16.0) | 11.0 (10.3–14.3) | 4 (3–6) | 5 (4–6) |
| Level 1 (156/1) | 1.3 (0.8–2.0) | 1.7 (1.7–1.7) | 1.2 (0.7–2.0) | 1.3 (1.3–1.3) | 9.7 (5.9–16.0) | 11.1 (11.1–11.1) | 4 (3–5) | 5 (5–5) |
| Level 2 (9/2) | 3.6 (1.5–5.1) | 3.4 (2.1–4.7) | 1.0 (0.8–3.1) | 3.0 (1.3–4.7) | 9.3 (5.5–29.0) | 16.3 (8.6–23.9) | 4 (4–6) | 7 (5–8) |
| Level 3 (2/1) | 1.4 (1.1–1.7) | 3.8 (3.8–3.8) | 1.2 (0.5–1.9) | 1.1 (1.1–1.1) | 8.8 (4.7–12.9) | 10.8 (10.8–10.8) | 5 (3–6) | 1 (1–1) |
| p-value (complexity levels) | 0.070 | 0.407 | 0.811 | 0.407 | 0.730 | 0.861 | 0.721 | 0.325 |
| p-value (PSC vs. w/o PSC | 0.036 | 0.408 | 0.447 | 0.622 | ||||
| Center 4 (254/20) | 1.6 (1.0–2.6) | 1.8 (1.5–2.2) | 1.5 (0.9–2.8) | 1.7 (0.9–2.0) | 7.0 (3.9–12.5) | 5.6 (3.9–7.4) | 3 (2–4) | 3 (2–4) |
| Level 1 (207/0) | 1.4 (1.0–2.3) | – | 1.4 (0.8–2.7) | – | 6.1 (3.6–11.4) | – | 3 (2–4) | – |
| Level 2 (8/16) | 1.7 (1.3–1.8) | 1.7 (1.2–2.0) | 1.0 (0.9–1.5) | 1.6 (0.9–1.8) | 4.8 (3.5–7.0) | 5.5 (3.3–6.7) | 3 (2–5) | 3 (3–4) |
| Level 3 (39/4) | 4.0 (1.8–5.5) | 2.4 (1.8–3.1) | 2.6 (1.7–3.9) | 2.0 (1.7–3.9) | 12.7 (8.4–18.0) | 7.7 (6.3–16.7) | 4 (2–5) | 4 (3–5) |
| p-value (complexity levels) | <0.001 | 0.178 | <0.001 | 0.122 | <0.001 | 0.122 | 0.009 | 0.682 |
| p-value (PSC vs. w/o PSC | 0.567 | 0.521 | 0.224 | 0.158 | ||||
| p-value (centers) | <0.001 | <0.001 | <0.001 | <0.001 | <0.001 | <0.001 | <0.001 | <0.001 |
ERCP, endoscopic retrograde cholangiopancreatography; KAP, kerma-area product; Ka,r, air-kerma at reference point; and PSC: primary sclerosing cholangitis. Results are given as median (IQR).