CC BY 4.0 · Endoscopy 2023; 55(12): 1103-1114
DOI: 10.1055/a-2131-7180
Original article

Global prospective case series of ERCPs using a single-use duodenoscope

Marco J. Bruno
1   Department of Gastroenterology and Hepatology, Erasmus Medical Center, University Medical Center, Rotterdam, The Netherlands
,
2   Department of Internal Medicine, Evangelisches Krankenhaus Düsseldorf, Düsseldorf, Germany
,
David Carr-Locke
3   Division of Gastroenterology & Hepatology, New York Presbyterian Hospital, Weill Cornell Medicine, New York, New York, USA
,
Prabhleen Chahal
4   Gastroenterology and Hepatology, Digestive Disease and Surgery Institute, Cleveland Clinic, Cleveland, Ohio, USA
,
5   Fondazione Policlinico Universitario Agostino Gemelli IRCCS (Università Cattolica del Sacro Cuore), Rome, Italy
,
Benedict Devereaux
6   Department of Gastroenterology, University of Queensland, Royal Brisbane and Women’s Hospital, Brisbane, Australia
,
Marc Giovannini
 7   Endoscopy Unit, Institut Paoli-Calmettes, Marseille, France
,
Mahesh K. Goenka
 8   Department of Gastroenterology, Apollo Multispecialty Hospitals, Kolkata, India
,
Christopher Khor
 9   Department of Gastroenterology and Hepatology, Singapore General Hospital, Singapore
,
James Lau
10   Prince of Wales Hospital, Hong Kong, China
,
Gary May
11   The Centre for Therapeutic Endoscopy and Endoscopic Oncology, Division of Gastroenterology, St. Michael’s Hospital, Alberta, Canada
,
V. Raman Muthusamy
12   Vatche and Tamar Manoukian Division of Digestive Diseases, David Geffen School of Medicine at UCLA, University of California, Los Angeles, California, USA
,
Sandeep Patel
13   Division of Gastroenterology, UT Health San Antonio, San Antonio, Texas, USA
,
Bret T. Petersen
14   Division of Gastroenterology and Hepatology, Mayo Clinic, Rochester, Minnesota, USA
,
15   Center for Advanced Endoscopy, Division of Gastroenterology, Beth Israel Deaconess Medical Center, and Harvard Medical School, Boston, Massachusetts, USA
,
Isaac Raijman
16   Texas International Endoscopy Center, Houston, Texas, USA
,
D. Nageshwar Reddy
17   Asian Institute of Gastroenterology, Hyderabad, India
,
Alessandro Repici
18   Endoscopy Unit, Humanitas Clinical and Research Center IRCCS, Rozzano, Milan, Italy
19   Department of Biomedical Sciences, Humanitas University, Rozzano, Milan, Italy
,
Andrew S. Ross
20   Department of Gastroenterology, Digestive Disease Institute, Virginia Mason Medical Center, Seattle, Washington
,
Divyesh V. Sejpal
21   Digestive Disease Institute, Dignity/CommonSpirit Health, Creighton School of Medicine, Phoenix, Arizona, USA
,
Stuart Sherman*
22   Division of Gastroenterology and Hepatology, Department of Medicine, Indiana University, Indianapolis, Indiana, USA
,
Uzma D. Siddiqui
23   Center for Endoscopic Research and Therapeutics (CERT), University of Chicago, Chicago, Illinois, USA
,
Christopher Ziady
24   Dr. George Mukhari Academic Medical Center, Pretoria, South Africa
,
Joyce A. Peetermans
25   Endoscopy Division, Boston Scientific Corporation, Marlborough, Massachusetts, USA
,
Matthew J. Rousseau
25   Endoscopy Division, Boston Scientific Corporation, Marlborough, Massachusetts, USA
,
Adam Slivka
26   Department of Gastroenterology, Hepatology, and Nutrition, University of Pittsburgh Medical Center, Pittsburgh, Pennsylvania, USA
,
EXALT Single-use Duodenoscope Study Group › Institutsangaben
Boston Scientific Corporation

Trial Registration: ClinicalTrials.gov Registration number (trial ID): NCT04103749 Type of study: Multi-Center Study


Abstract

Background The first commercialized single-use duodenoscope was cleared by the US Food and Drug Administration in December 2019. Data regarding endoscopic retrograde cholangiopancreatography (ERCP) using a single-use duodenoscope are needed on a broader range of cases conducted by endoscopists with varying levels of experience in a wide range of geographic areas.

Methods 61 endoscopists at 22 academic centers in 11 countries performed ERCP procedures in adult patients aged ≥ 18. Outcomes included ERCP completion for the intended indication, rate of crossover to a reusable endoscope, device performance ratings, and serious adverse events (SAEs).

Results Among 551 patients, 236 (42.8 %) were aged > 65, 281 (51.0 %) were men, and 256 (46.5 %) had their procedure as an inpatient. ERCPs included 196 (35.6 %) with American Society for Gastrointestinal Endoscopy complexity of grades 3–4. A total of 529 ERCPs (96.0 %) were completed: 503 (91.3 %) using only the single-use duodenoscope, and 26 (4.7 %) with crossover to a reusable endoscope. There were 22 ERCPs (4.0 %) that were not completed, of which 11 (2.0 %) included a crossover and 11 (2.0 %) were aborted cases (no crossover). Median ERCP completion time was 24.0 minutes. Median overall satisfaction with the single-use duodenoscope was 8.0 (scale of 1 to 10 [best]). SAEs were reported in 43 patients (7.8 %), including 17 (3.1 %) who developed post-ERCP pancreatitis.

Conclusions In academic medical centers over a wide geographic distribution, endoscopists with varying levels of experience using the first marketed single-use duodenoscope had good ERCP procedural success and reported high performance ratings for this device.

* Deceased; this paper is dedicated to our friend and eminent colleague gastroenterologist Dr. Stuart Sherman.




Publikationsverlauf

Eingereicht: 13. März 2023

Angenommen nach Revision: 14. Juli 2023

Accepted Manuscript online:
18. Juli 2023

Artikel online veröffentlicht:
20. September 2023

© 2023. The Author(s). This is an open access article published by Thieme under the terms of the Creative Commons Attribution License, permitting unrestricted use, distribution, and reproduction so long as the original work is properly cited. (https://creativecommons.org/licenses/by/4.0/)

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