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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

 

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