EUS vs MRCP Carbon Footprint: EUS 4.2 Times Lower for Bile Duct Stone Evaluation

For intermediate-likelihood choledocholithiasis, EUS generates 4.53 kg CO2e per procedure vs 18.90 kg for MRCP—a 4.2-fold difference. Choosing EUS for 108 patients saved 1,552 kg CO2e (74 trees' annual carbon uptake).

• Prospective study measuring per-procedure carbon footprint of EUS and MRCP for suspected CBD stones.
• MRCP's continuously running cryocooler accounted for 23.4% of its standby emissions and was the largest fixed contributor, absent in EUS.
• On low-carbon grids, the carbon advantage of EUS narrowed and could reverse, making local energy mix a key consideration.

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