Conventional endoscopic retrograde cholangiopancreaticographyvsthe Olympus V-scope system

Abstract

ERCP using the short-guidewire V-system did not significantly improve ERCP performance or patient outcomes, but it may reduce and simplify the ERCP procedure in difficult settings.

What is Best Testing Ground for Clinical Evaluation of Single-use Duodenoscopes?

“…2 In fact, the Rome IV criteria uses the BSFS for subtyping irritable bowel syndrome, 3 and the U.S. Food and Drug Administration recommends the BSFS as the primary endpoint of irritable bowel syndrome with diarrhea trials. 4 We also agree that there may have been some inherent limitations in the measurement of dietary intake. Oungpasuk et al raise the concern that although we included milk consumption, we did not include all dairy consumption.…”

“…1 Interestingly, even in other comparative studies focused on clinical performance of new different duodenoscopes, although reusable, the naive patient rate represented in the study populations varies widely from 100% to 0%. [4][5] For example, in a study on a new reusable duodenoscope with a specific design aimed to make accessory exchange faster and safer, improve guidewire handling, and increase hygienic aspects of ERCP, only patients with previous sphincterotomy were enrolled. 4 Because performance measures of ERCP include technical success at biliary ERCP, predicated on the rate of successful deep cannulation of the duct, patients with prior sphincterotomy should not be included in the calculation of cannulation rate.…”

“…[4][5] For example, in a study on a new reusable duodenoscope with a specific design aimed to make accessory exchange faster and safer, improve guidewire handling, and increase hygienic aspects of ERCP, only patients with previous sphincterotomy were enrolled. 4 Because performance measures of ERCP include technical success at biliary ERCP, predicated on the rate of successful deep cannulation of the duct, patients with prior sphincterotomy should not be included in the calculation of cannulation rate. 4 Furthermore, a high rate of patients with previous sphincterotomy in the study group represents a limitation in the assessment of the endoscope safety.…”

“…4 Because performance measures of ERCP include technical success at biliary ERCP, predicated on the rate of successful deep cannulation of the duct, patients with prior sphincterotomy should not be included in the calculation of cannulation rate. 4 Furthermore, a high rate of patients with previous sphincterotomy in the study group represents a limitation in the assessment of the endoscope safety.…”

“…In a bench randomized controlled trial 3 and our clinical case series, 2 expert endoscopists documented high median ratings (8-10/10 and 4-5/5) for functional measures of the new device compared with their usual reusable duodenoscope. Thus, the assumption of equal functionality in Bang et al's cost analysis 4 is reasonable, at least for expert users. Bang et al's analysis suggested that the cost of a disposable duodenoscope varies depending on infection rates and endoscopic retrograde cholangiopancreatography (ERCP) procedure volume.…”