Duodenoscope-related infections and potential role of single-use duodenoscopes

Holzwanger, Erik; Bilal, Mohammad; Saperia, James; Cohen, Jonah; Sawhney, Mandeep S.; Berzin, Tyler M.; Pleskow, Douglas K.

doi:10.1016/j.vgie.2020.08.011

Cited by 8 publications

(7 citation statements)

References 5 publications

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“…To date, no SUD-related adverse event was ever reported. 7,8,10 Our study included patients with different indications for ERCP and, therefore, several techniques and procedures of all levels of complexity have been performed using various endoscopic devices. The operators involved in our study were able to perform all planned biliary interventions, including advanced cannulation techniques, stone clearance, stent placement and retrieval, stricture dilation and tissue acquisition.…”

Section: Discussionmentioning

confidence: 99%

Evaluation of the performances of a single‐use duodenoscope: Prospective multi‐center national study

Napoléon

Gonzalez

Grandval

et al. 2021

Digestive Endoscopy

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Objectives: A single-use duodenoscope (SUD) has been recently developed to overcome issues with endoscopic retrograde cholangiopancreatography (ERCP)-related cross-infections. The aim was to evaluate SUD safety and performance in a prospective multi-centre study. Methods: All consecutive patients undergoing ERCP in sixFrench centers were prospectively enrolled. All procedures were performed with the SUD; in case of ERCP failure, operators switched to a reusable duodenoscope. Study outcomes were the successful completion of the procedure with SUD, safety and operators' satisfaction based on a VAS 0-10 and on 22 qualitative items. The study protocol was approved by French authorities and registered (ID-RCB: 2020-A00346-33). External companies collected the database and performed statistical analysis.Results: Sixty patients (34 females, median age 65.5 years old) were enrolled. Main indications were bile duct stones (41.7%) and malignant biliary obstruction (26.7%). Most ERCP were considered ASGE grade 2 (58.3%) or 3 (35.0%). Fifty-seven (95.0%) procedures were completed using the SUD. Failures were unrelated to SUD (one duodenal stricture, one ampullary infiltration, and one tight biliary stricture) and could not be completed with reusable duodenoscopes. Median operators' satisfaction was 9 (7-9). Qualitative assessments were considered clinically satisfactory in a median of 100% of items and comparable to a reusable duodenoscope in 97.9% of items. Three patients (5%) reported an adverse event. None was SUDrelated. Conclusions:The use of a SUD allows ERCP to be performed with an optimal successful rate. Our data show that SUD could be used for several ERCP indications and levels of complexity.

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Section: Discussionmentioning

confidence: 99%

Evaluation of the performances of a single‐use duodenoscope: Prospective multi‐center national study

Napoléon

Gonzalez

Grandval

et al. 2021

Digestive Endoscopy

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“…Fully disposable duodenal scopes have been produced and have received FDA approval. 28 Early experience suggests there are comparable to reusable scopes in respects to their handling and ability to perform ERCPs. 29,30 Duodenal scopes are not the only scopes that have started to shift to disposable instruments for infection control.…”

Section: Discussionmentioning

confidence: 99%

“…Recently, the use of disposable endcaps and elevators have become more common. Fully disposable duodenal scopes have been produced and have received FDA approval 28. Early experience suggests there are comparable to reusable scopes in respects to their handling and ability to perform ERCPs 29,30.…”

Section: Discussionmentioning

confidence: 99%

Transcystic Choledochoscopy Utilizing a Disposable Choledochoscope: How We Do It

Campbell

Pryor

Docimo

2022

Surgical Laparoscopy, Endoscopy &Amp; Percutaneous Techniques

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Background: Biliary disease is common occurrence and can make up a large portion of the practice of a general surgeon. Choledocholithasis is a common entity amongst those with biliary disease. Although modern trends favor endoscopic retrograde cholangiopancreatography (ERCP) and other imaging modalities for the diagnosis and management of choledocholithiasis, laparoscopic common bile duct exploration (LCBDE) is likely underutilized.Methods: A literature summary utilizing a PUBMED search was performed to provide an up-to-date account regarding the latest data on LCBDE. A video identifying and explaining the critical components of a LBCDE procedure is provided.Results: LCBDE is an underutilized procedure which offers equivalent clinical outcomes compared with ERCP along with a shorter length of stay and reduced costs. LCBDE is also noted to be an effective option for common bile duct stones in the setting of altered anatomy, such as a Roux-en-Y gastric bypass. Conclusion:Although modern trends favor ERCP and other imaging modalities for the diagnosis and management of choledocholithiasis, LCBDE is likely underutilized by surgeons. LCBDE can provide many benefits to patients including avoidance of additional procedures, shorter length of stay, higher success rates, and less costs. Out video should act is a guide for those surgeons interested in implementation LCBDE in their practice.

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“…Based on hospital contractual agreements with Boston Scientific Corporation, the Exalt Model D single-use duodenoscope is presently available in the USA between USD 1900 and USD 4,000 [ 9 ]. It is currently unknown how this additional cost will be covered by insurance.…”

Section: Discussion/conclusionmentioning

confidence: 99%

Esophageal Perforation after Using a Single-Use Disposable Duodenoscope

Cheema

Ghali

Schey

et al. 2021

Case Rep Gastroenterol

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The Food and Drug Administration (FDA) has recently released a safety communication recommending transition to duodenoscopes with innovative designs that facilitate or eliminate the need for reprocessing. Thus, there has been a significant amount of development into disposable duodenoscope components and single-use duodenoscopes, with variable tactile feedback. We describe a case of esophageal perforation after using a single-use disposable duodenoscope (EXALT Model D; Boston Scientific Corporation, Marlborough, MA, USA). To our knowledge, this is the first reported case of an esophageal perforation since FDA approval of this device in December 2019. ERCP was performed with the EXALT Model D single-use duodenoscope (Boston Scientific Corporation) by an experienced gastroenterologist. During the procedure, gentle force applied through the gastroesophageal junction caused a liner perforation in the distal esophagus. An esophageal stent was placed with satisfactory wound healing and no fistula formation. There have been a few reports in the last 2 years showing promising results using this device; however, the differences in the tactile feedback, navigation, and pushability of the device may make it prone to unintended consequences.

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Duodenoscope-related infections and potential role of single-use duodenoscopes

Cited by 8 publications

References 5 publications

Evaluation of the performances of a single‐use duodenoscope: Prospective multi‐center national study

Evaluation of the performances of a single‐use duodenoscope: Prospective multi‐center national study

Transcystic Choledochoscopy Utilizing a Disposable Choledochoscope: How We Do It

Esophageal Perforation after Using a Single-Use Disposable Duodenoscope

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