“…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.…”