The use of ionizing radiation during endoscopic retrograde cholangiopancreatography (ERCP) is a significant quality problem, particularly in youngsters. For a study, researchers sought to determine parameters related to prolonged fluoroscopy time (FT) in children having ERCP. From May 2014 to May 2018, ERCP on minors aged 18 were input prospectively into a REDCap database from 15 sites. Data for the outcome and quality metrics were examined retrospectively. To identify parameters related to higher FT, a univariate and stepwise linear regression analysis was done.

Inclusion criteria were satisfied by 1,073 ERCPs conducted on 816 different patients. The median age was 12.2 (interquartile range [IQR] 9.3–15.8). 767 patients (71%) had native papillae. The median FT was 120 seconds (interquartile range: 60–240). Procedures performed on chronic pancreatitis patients, ERCPs with an American Society of Gastrointestinal Endoscopy (ASGE) difficulty grade of 3 or higher, ERCPs performed by pediatric gastroenterologists (GI) with adult GI supervision, and ERCPs performed at non-freestanding children’s hospitals were all associated with increased FT. The only element linked to reduced FT was Hispanic ethnicity.

In juvenile ERCP, several characteristics were related to extended FTs that differed from adult studies. It emphasized the fact that adult quality metrics were not always applicable to juvenile patients. The information could be used to better identify children who were at a higher risk of radiation exposure and to enhance the quality of outcomes after pediatric ERCP.