Prospective Comparison of the Carbon Footprint of EUS vs MRCP for Evaluation of Suspected Choledocholithiasis

Prospective Comparison of the Carbon Footprint of Endoscopic Ultrasound (EUS) vs Magnetic Resonance Cholangiopancreatography (MRCP) for Evaluation of Suspected Choledocholithiasis

MRCP and EUS are diagnostically equivalent in detecting CBD stones among patients with intermediate risk, as shown in a landmark RCT. However, MRI-based imaging is power-intensive, requiring large infrastructure and long scan durations. EUS, a less energy-consuming and portable procedure, has the added advantage of enabling same-session ERCP, reducing the need for repeat procedures.

MRCP and EUS are diagnostically equivalent in detecting CBD stones among patients with intermediate risk, as shown in a landmark RCT. However, MRI-based imaging is power-intensive, requiring large infrastructure and long scan durations. EUS, a less energy-consuming and portable procedure, has the added advantage of enabling same-session ERCP, reducing the need for repeat procedures. Prior research confirms that diagnostic EUS generates significantly less CO₂e per procedure compared to radiologic imaging. This study aims to support sustainable diagnostic choices by quantifying their environmental footprint.

Inclusion Criteria:

• Age ≥18 years
• Intermediate likelihood of CBD stone (per ESGE)
• Undergoing either MRCP or EUS for evaluation

Exclusion Criteria:

• High or low likelihood category (per ESGE)
• Undergoing both MRCP and EUS simultaneously
• Contraindications to either modality