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CC BY-NC-ND 4.0 · Endosc Int Open 2022; 10(11): E1497-E1500
DOI: 10.1055/a-1921-2109
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Single-use duodenoscopes are an efficient tool for emergency ERCP in real life

Paul Rivallin
1   Endoscopy Unit, Beaujon Hospital, Clichy la Garenne, France, AP-HP, 100 boulevard du general Leclerc, 92110 Clichy la Garenne, France
,
Diane Lorenzo
1   Endoscopy Unit, Beaujon Hospital, Clichy la Garenne, France, AP-HP, 100 boulevard du general Leclerc, 92110 Clichy la Garenne, France
,
Abdellah Hedjoudje
1   Endoscopy Unit, Beaujon Hospital, Clichy la Garenne, France, AP-HP, 100 boulevard du general Leclerc, 92110 Clichy la Garenne, France
,
Frédéric Prat
1   Endoscopy Unit, Beaujon Hospital, Clichy la Garenne, France, AP-HP, 100 boulevard du general Leclerc, 92110 Clichy la Garenne, France
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Abstract

Background Biliary tract emergencies are managed with endoscopic retrograde cholangiopancreatography (ERCP) using duodenoscopes, which are reusable devices that require high-level disinfection to minimize risk of cross-contamination. Recent reports about newly developed single-use duodenoscopes (SUDs) suggest equivalent performance with reusable duodenoscopes, but the effectiveness of SUDs in emergency ERCP has not yet been studied.

Patients and methods We conducted a prospective case series of emergency ERCP procedures using SUDs (EXALT model D-Boston Scientific, United States) in a real-life, tertiary care setting without any possibility of using a back-up reusable duodenoscope.

Results Twenty-one emergent ERCPs (acute cholangitis 48%, severe jaundice 38 %, others 14 %) were performed in 19 patients (mean age 49.5±15 years). Almost all procedures (20 of 21; 95 %) were technically and clinically successful, whereas selective cannulation failed in one case. Among the successful ERCPs, five (24 %) were achieved by a novice operator. The image was often considered skewed toward yellow tones (48 %), whereas stiffness and pushability for stent insertion were found suboptimal in 5 % of the procedures, without any impact on procedure success.

Conclusions SUDs are effective and appropriate devices for emergent situations in real life even in non-expert hands and even if a regular duodenoscope is unavailable as a backup.



Publication History

Received: 09 February 2022

Accepted after revision: 20 May 2022

Accepted Manuscript online:
09 August 2022

Article published online:
15 November 2022

© 2022. The Author(s). This is an open access article published by Thieme under the terms of the Creative Commons Attribution-NonDerivative-NonCommercial License, permitting copying and reproduction so long as the original work is given appropriate credit. Contents may not be used for commercial purposes, or adapted, remixed, transformed or built upon. (https://creativecommons.org/licenses/by-nc-nd/4.0/)

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Comment to this article:

Endoscopy International Open – recently publishedEndoscopy 2022; 54(12): 1236-1236
DOI: 10.1055/a-1899-3772

 

  • References

  • 1 Rauwers AW, Kwakman JA, Vos MC. et al. Endoscope-associated infections: A brief summary of the current state and views toward the future. Tech Gastrointest Endosc 2019; 21: 150608
    CrossrefPubMedGoogle Scholar
  • 2 Rauwers AW, Voor in’t holt AF, Buijs JG. et al. High prevalence rate of digestive tract bacteria in duodenoscopes: a nationwide study. Gut 2018; 67: 1637-1645
    Google Scholar
  • 3 Peter S, Bang JY, Varadarajulu S. Single-use duodenoscopes: where are we and where are we going?. Curr Opin Gastroenterol 2021; 37: 416-420
    CrossrefPubMedGoogle Scholar
  • 4 Bang JY, Hawes R, Varadarajulu S. Equivalent performance of single-use and reusable duodenoscopes in a randomised trial. Gut 2021; 70: 838-844
    Google Scholar
  • 5 Bulut M, Hjørne F, Knuhtsen S. et al. Sterile laparoscopic transgastric ERCP with single-use disposable duodenoscope. Endoscopy 2021; DOI: 10.1055/a-1508-5664.
    Article in Thieme ConnectPubMedGoogle Scholar
  • 6 Ehrlich D, Muthusamy VR. Device profile of the EXALT Model D single-use duodenoscope for endoscopic retrograde cholangiopancreatography: overview of its safety and efficacy. Expert Rev Med Devices 2021; 18: 421-427
    CrossrefPubMedGoogle Scholar
  • 7 Muthusamy VR, Bruno MJ, Kozarek RA. et al. Clinical evaluation of a single-use duodenoscope for endoscopic retrograde cholangiopancreatography. Clin Gastroenterol Hepatol Off Clin Pract J Am Gastroenterol Assoc 2020; 18: 2108-2117.e3
    PubMedGoogle Scholar
  • 8 Reddy DN, Ramchandani M, Lakhtakia S. et al. Single-use duodenoscope in the management of an elderly patient with difficult bile duct stones: laser lithotripsy using a disposable cholangioscope. VideoGIE 2021; 6: 319-321
    CrossrefPubMedGoogle Scholar
  • 9 Ross AS, Bruno MJ, Kozarek RA. et al. Novel single-use duodenoscope compared with 3 models of reusable duodenoscopes for ERCP: a randomized bench-model comparison. Gastrointest Endosc 2019; S0016510719322011 DOI: 10.1016/j.gie.2019.08.032.
    CrossrefPubMedGoogle Scholar
  • 10 Slivka A, Ross AS, Sejpal DV. et al. Single-use duodenoscope for ERCP performed by endoscopists with a range of experience in procedures of variable complexity. Gastrointest Endosc 2021; DOI: 10.1016/j.gie.2021.06.017.
    CrossrefPubMedGoogle Scholar
  • 11 Napoléon B, Gonzalez J, Grandval P. et al. Evaluation of the performances of a single‐use duodenoscope: Prospective multi‐center national study. Dig Endosc 2021; DOI: 10.1111/den.13965.
    CrossrefPubMedGoogle Scholar
  • 12 Singer M, Deutschman CS, Seymour CW. et al. The Third International Consensus Definitions for Sepsis and Septic Shock (Sepsis-3). JAMA 2016; 315: 801-810
    Google Scholar
  • 13 Schutz SM, Abbott RM. Grading ERCPs by degree of difficulty: a new concept to produce more meaningful outcome data. Gastrointest Endosc 2000; 51: 535-539
    CrossrefPubMedGoogle Scholar
  • 14 Baker N, Bromley-Dulfano R, Chan J. et al. COVID-19 solutions are climate solutions: lessons from reusable gowns. Front Public Health 2020; 8: 590275
    CrossrefPubMedGoogle Scholar