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World J Gastrointest Endosc. Aug 16, 2013; 5(8): 366-368
Published online Aug 16, 2013. doi: 10.4253/wjge.v5.i8.366
Fetal radiation exposure: Is monitoring really needed?
Milena Di Leo, Paolo Giorgio Arcidiacono
Milena Di Leo, Paolo Giorgio Arcidiacono, Endoscopy Unit, Gastroenterology and Gastrointestinal Endoscopy Unit, Vita Salute San Raffaele University, San Raffaele Scientific Institute, 20132 Milano, Italy
Author contributions: Di Leo M, Arcidiacono PG contributed to conception and design, acquisition and interpretation of data, drafting the article and final approval of the version to be published.
Correspondence to: Paolo Giorgio Arcidiacono, MD, FASGE, Chief Endoscopy Unit, Gastroenterology and Gastrointestinal Endoscopy Unit, Vita Salute San Raffaele University, San Raffaele Scientific Institute, Via Olgettina 60, 20132 Milano, Italy. arcidiacono.paologiorgio@hsr.it
Telephone: +39-2-26436306 Fax: +39-2-26435609
Received: February 17, 2013
Revised: April 10, 2013
Accepted: May 8, 2013
Published online: August 16, 2013
Processing time: 176 Days and 19.2 Hours
Abstract

The effect of fetal radiation during endoscopic retrograde cholangiopancreatography (ERCP) on pregnant women is a very interesting topic. Smith et al recently estimated the fetal radiation exposure in pregnant women undergoing ERCPs using thermoluminescent dosimeters (TLDs). The authors concluded that TLDs are unnecessary during ERCP with modified techniques. We believe that an extreme caution is needed in clinical practice before drawing such conclusions when they are not strongly supported by enough experimental evidence. Therefore, we recommend that fetal radiation exposure be monitored in clinical practice by using dosimeters, bearing in mind that all relevant techniques to control and minimize the exposure must be applied.

Keywords: Endoscopic retrograde cholangiopancreatography; Pregnancy; Fetal radiation exposure; Thermoluminescent dosimeters; Post-endoscopic retrograde cholangio-pancreatography pancreatitis

Core tip: The effects of endoscopic retrograde cholangiopancreatography (ERCP) on pregnant women, addressed in the recent article by Smith et al, is an interesting topic. Despite the large sample of patients investigated by the authors, strong experimental evidence on this topic is still lacking. ERCP should be performed only with a therapeutic purpose and by experienced ERCP endoscopists, preferably during the second trimester of pregnancy.