{
  "abstract": "Background Endoscopic Retrograde Cholangio-Pancreaticography (ERCP) during pregnancy is indicated for symptomatic biliary obstruction due to stones and or cholangitis. Although Fetal Radiation exposure during standard ERCP during Pregnancy is typically below teratogenic thresholds by minimising radiation, adhering to the ALARA principle. However, concern about Organogenesis defects if exposed in the first trimester and later stochastic Carcinogenic risk may be at the back of mind. Contrast exposure can also be avoided. We report a case series of three Pregnant patients who underwent ultrasound-guided ERCP without any fluoroscopy.Methods Three pregnant patients with symptomatic biliary obstruction were included in the series. The patients’ characteristics have been described in Table 1 ( IDDF2026-ABS-0379 Table 1).They underwent Radiation-free ERCP using wire-guided canulation, as shown in Figure 2 (IDDF2026-ABS-0379 Figure 2. CBD cannulation), from one of the patients, with real-time transabdominal Ultrasound confirmation of guidewire placement, as shown in Figure 1 (IDDF2026-ABS-0379 Figure 1. Real-time USG visualisation of the guidewire in the CBD). Biliary Sphincterotomy was done as shown in Figure 3 (IDDF2026-ABS-0379 Figure 3. Biliary sphincterotomy), and then CBD clearance was done with Balloon trawl as shown in Figure 4 (IDDF2026-ABS-0379 Figure 4. Balloon trawl CBD cleared). Maternal and fetal monitoring was done during the procedure.Results All three procedures were technically successful without any use of Fluoroscopy. Complete ductal clearance was achieved in all cases. No maternal procedure-related complications occurred. Fetal monitoring before and after the procedure was reassuring in all three patients. Pregnancy continued without any adverse events in all three of them. The patients’ outcomes are described in Table 2 ( IDDF2026-ABS-0379 Table 2).Conclusions Ultrasound-guided ERCP without Fluoroscopy is feasible and safe in selected pregnant patients when performed by experienced Endoscopists with a multi-disciplinary approach. This technique eliminated any fetal radiation exposure while maintaining therapeutic efficiency.Abstract IDDF2026-ABS-0379 Table 2Patient/factorTherapeutic SuccessComplicationsFetal Monitoring1st patientYesNoneNormal FHR before and after ERCP2nd patientYesNoneNormal FHR before and after ERCP3rd patientYesNoneNormal FHR before and after ERCPAbstract IDDF2026-ABS-0379 Figure 1Abstract IDDF2026-ABS-0379 Figure 2Abstract IDDF2026-ABS-0379 Table 1Patient/ FactorAgeGestational AgeIndication for ERCPReal Time USG-WireBiliary Sphincterotomy1st Patient26 years30 weeksCholangitis-CBD Cal.VisualisedYes2nd patient22 years18 weeksObstructive jaundice-CBD Cal.VisualisedYes3rd patient24 years26 weeksBiliary Pain-CBD Cal.VisualisedYesAbstract IDDF2026-ABS-0379 Figure 3Abstract IDDF2026-ABS-0379 Figure 4",
  "authors": [
    {
      "affiliations": [
        "Yashoda Hospital, India"
      ],
      "name": "Viswanath Reddy Donapati"
    },
    {
      "affiliations": [
        "Yashoda Hospital, India"
      ],
      "name": "Ravi Shankar B"
    },
    {
      "affiliations": [
        "Yashoda Hospital, India"
      ],
      "name": "Guduru R Srinivas Rao"
    }
  ],
  "title": "IDDF2026-ABS-0379 Radiation free ercp during pregnancy: a case series",
  "uid": "7d7c31b6-6d7d-5342-970d-0bddb1a23c13"
}