Single-use duodenoscope for ERCP performed by endoscopists with a range of experience in procedures of variable complexity

Slivka, Adam; Ross, Andrew; Sejpal, Divyesh V.; Petersen, Bret T.; Bruno, Marco J.; Pleskow, Douglas K.; Muthusamy, V. Raman; Chennat, Jennifer; Krishnamoorthi, Rajesh; Lee, Calvin; Martin, John A.; Poley, Jan–Werner; Cohen, Jonah; Peetermans, Joyce; Rousseau, Matthew; Tirrell, Gregory Philip; Kozarek, Richard A.; Khalid, Asif; Das, Rohit; Singh, Harkirat; Vipperla, Kishore; Antony, Andrew; Choi, Jun‐Ho; Larsen, Michael; Law, Joanna K.; Klair, Jagpal S.; Thaker, Adarsh M.; Dayyeh, Barham Abu; Chandrasekhara, Vinay; Levy, Michael J.; Law, Ryan; Insull, Jeff

doi:10.1016/j.gie.2021.06.017

Cited by 27 publications

(36 citation statements)

References 26 publications

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“…In this context, single-use duodenoscopes (SUDs) have been recently developed as an alternative to scope reprocessing. The usefulness and effectiveness of SUDs has been the subject of few publications [4][5][6][7][8][9][10][11], including arandomized trial showing equivalent performances of singleuse and reusable duodenoscopes and similar success on low-complexity procedures [4].…”

Section: Introductionmentioning

confidence: 99%

Single-use duodenoscopes are an efficient tool for emergency ERCP in real life

et al. 2022

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Background: Biliary emergencies are managed by endoscopic retrograde cholangiopancreatography (ERCP) using duodenoscopes which are reusable devices requiring high-level disinfection to minimize the risk of cross-contamination. Recent reports on newly developed single-use duodenoscopes (SUDs) suggest equivalent performance with reusable duodenoscopes, but the effectiveness of SUDs in emergency ERCP has not been studied yet. Method: We conducted a prospective case series of emergency ERCP procedures using SUDs (EXALT model D-Boston Scientific, USA) in a real life, tertiary care setting without any possibility of a reusable duodenoscope back-up. Results: During 3 weeks, 22 emergent ERCPs (acute cholangitis 48%, severe jaundice 38%, others 14%) were performed in 19 patients (mean age 49.5 ± 15 years). Almost all procedures (21/22; 95%) were technically and clinically successful, whereas selective cannulation failed in one. Of the successful ERCPs, 2 (5%) were achieved by a novice operator. The image was often considered skewed towards yellow tones (50%) whereas stiffness and pushability for stent insertion were found suboptimal in 5% of the procedures, with no prejudice to procedural success. Conclusion: SUDs are effective devices, appropriate for emergent situations in real life even in non-expert hands and even if a regular duodenoscope backup is unavailable.

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Section: Introductionmentioning

confidence: 99%

Single-use duodenoscopes are an efficient tool for emergency ERCP in real life

et al. 2022

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“…If we compare our observations to reported series using the same single-use duodenoscope [ 1 , 9 - 11 ] ( Table 4 ), results are quite comparable in over 433 patients in terms of crossover rate (overall average 6.3%), procedural completion rate (overall average 94.8%), performance characteristics (overall average 4.5/5), overall satisfaction (overall average 8.5/10), and safety. From the perspective of clinical use, these data are encouraging and set the stage for further development and optimization of a single-use duodenoscope platform, as this is the only clinical pathway at present that carries a zero risk of patient-to-patient transferred DRIs, the ultimate safety prerequisite for any given patient.…”

Section: Discussionmentioning

confidence: 55%

“…The DRI issue could not be more contemporary, if one considers the highly contagious COVID-19 pandemic and its inherent risk of aerosolization during disinfection [ 8 ]. Recently, Boston-Scientific introduced the first approved single-use, sterile duodenoscope, Exalt™ Model D. Until now, 4 reports have been published on this device in 381 patients overall [ 1 , 9 - 11 ] ( Fig. 1 ).…”

Section: Introductionmentioning

confidence: 99%

Performance and applicability of a first generation single use duodenoscope: a single-center cohort study

Persyn

Malenstein²,

Vanderschueren³

et al. 2022

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“…If we compare our observations to reported series using the same single-use duodenoscope [1,[9][10][11] (Table 4), results are quite comparable in over 433 patients in terms of crossover rate (overall average 6.3%), procedural completion rate (overall average 94.8%), performance characteristics (overall average 4.5/5), overall satisfaction (overall average 8.5/10), and safety. From the perspective of clinical use, these data are encouraging and set the stage for further development and optimization of a single-use duodenoscope platform, as this is the only clinical pathway at present that carries a zero risk of patient-to-patient transferred DRIs, the ultimate safety prerequisite for any given patient.…”

Section: Ercp Endoscopic Retrograde Cholangiopancreatographymentioning

confidence: 59%

“…The DRI issue could not be more contemporary, if one considers the highly contagious COVID-19 pandemic and its inherent risk of aerosolization during disinfection [8]. Recently, Boston-Scientific introduced the first approved singleuse, sterile duodenoscope, Exalt™ Model D. Until now, 4 reports have been published on this device in 381 patients overall [1,[9][10][11] (Fig. 1).…”

Section: Introductionmentioning

confidence: 99%