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

ABSTRACT:

SUBMITTER: Holzwanger EA

PROVIDER: S-EPMC7530557 | biostudies-literature | 2020 Dec

REPOSITORIES: biostudies-literature

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

Holzwanger Erik A EA Bilal Mohammad M Saperia James J Cohen Jonah J Sawhney Mandeep S MS Berzin Tyler M TM Pleskow Douglas K DK

VideoGIE : an official video journal of the American Society for Gastrointestinal Endoscopy 20201002 12

PMID: 33024906

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Project description:ObjectiveSingle-use duodenoscopes have been recently developed to eliminate risk of infection transmission from contaminated reusable duodenoscopes. We compared performances of single-use and reusable duodenoscopes in patients undergoing endoscopic retrograde cholangiopancreatography (ERCP).DesignPatients with native papilla requiring ERCP were randomised to single-use or reusable duodenoscope. Primary outcome was comparing number of attempts to achieve successful cannulation of desired duct. Secondary outcomes were technical performance that measured duodenoscope manoeuvrability, mechanical-imaging characteristics and ability to perform therapeutic interventions, need for advanced cannulation techniques or cross-over to alternate duodenoscope group to achieve ductal access and adverse events.Results98 patients were treated using single-use (n=48) or reusable (n=50) duodenoscopes with >80% graded as low-complexity procedures. While median number of attempts to achieve successful cannulation was significantly lower for single-use cohort (2 vs 5, p=0.013), ease of passage into stomach (p=0.047), image quality (p<0.001), image stability (p<0.001) and air-water button functionality (p<0.001) were significantly worse. There was no significant difference in rate of cannulation, adverse events including mortality (one patient in each group), need to cross-over or need for advanced cannulation techniques to achieve ductal access, between cohorts. On multivariate logistic regression analysis, only duodenoscope type (single-use) was associated with less than six attempts to achieve selective cannulation (p=0.012), when adjusted for patient demographics, procedural complexity and type of intervention.ConclusionGiven the overall safety profile and similar technical performance, single-use duodenoscopes represent an alternative to reusable duodenoscopes for performing low-complexity ERCP procedures in experienced hands.Trial registration numberClinicaltrials.gov number: NCT04143698.

Dataset Information

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

Publications

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

Similar Datasets

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