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Review
. 2023 Aug 5;13(8):1694.
doi: 10.3390/life13081694.

Disposable Duodenoscopes: Evidence and Open Issues

Clara Benedetta Conti  1 , Fabrizio Cereatti  2 , Raffaele Salerno  3 , Roberto Grassia  4 , Miki Scaravaglio  1 , Carmen Laurenza  4 , Marco Emilio Dinelli  1
Affiliations
Review

Disposable Duodenoscopes: Evidence and Open Issues

Clara Benedetta Conti et al. Life (Basel). .

Abstract

Duodenoscope-related infections are a major concern in medicine and GI endoscopy, especially in fragile patients. Disposable duodenoscopes seem to be the right tool to minimize the problem: a good choice for patients with many comorbidities or with a high risk of carrying multidrug resistant bacteria. Urgent endoscopy could also be a good setting for the use of single-use duodenoscopes, especially when the risk of the infection cannot be evaluated. Their safety and efficacy in performing ERCP has been proven in many studies. However, randomized clinical trials and comparative large studies with reusable scopes are lacking. Moreover, the present early stage of their introduction on the market does not allow a large economical evaluation for each health system. Thus, accurate economical and safety comparisons with cap-disposable duodenoscopes are needed. Moreover, the environmental impact of single-use duodenoscopes should be carefully evaluated, considering the ongoing climate change. In conclusion, definitive guidelines are needed to choose wisely the appropriate patients for ERCP with disposable duodenoscopes as the complete switch to single-use duodenoscopes seems to be difficult, to date. Many issues are still open, and they need to be carefully evaluated in further, larger studies.

Keywords: cap disposable duodenoscopes; economic impact; endoscopic retrograde cholangiopancreatography; environmental impact; single-use duodenoscopes.

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Conflict of interest statement

The authors declare no conflict of interest.

Figures

Figure 1
Figure 1
High-level disinfection and reprocessing machine for endoscopy.
Figure 2
Figure 2
(A,B): X-ray image of an ERCP procedure with Ambu Single-Use Duodenoscope. Two different cases of elderly patients with cholangitis and many comorbidities. They had stones in the main bile duct that were successfully removed with basket.
Figure 3
Figure 3
(A,B): X-ray image of an ERCP procedure with Ambu Single-Use Duodenoscope. The patient had a Klatskin tumor. The main bile duct was successfully cannulated (A) and a metal stent was delivered without any technical problems (B).
Figure 4
Figure 4
(A,B): X-ray image (A) and endoscopic view (B) of ERCP procedures and stones removal with Exalt D Single-Use Duodenoscope in a fragile patient prone to develop infection.
Figure 4
Figure 4
(A,B): X-ray image (A) and endoscopic view (B) of ERCP procedures and stones removal with Exalt D Single-Use Duodenoscope in a fragile patient prone to develop infection.
See this image and copyright information in PMC

References

    1. Epstein L., Hunter J.C., Arwady M.A., Tsai V., Stein L., Gribogiannis M., Frias M., Guh A.Y., Laufer A.S., Black S., et al. New Delhi metallo-β-lactamase-producing carbapenem-resistant Escherichia coli associated with exposure to duodenoscopes. JAMA. 2014;312:1447–1455. doi: 10.1001/jama.2014.12720. - DOI - PMC - PubMed
    1. Cooke R., Hughes J., Kaufmann P. P14.18 An Outbreak of ESBL Klebsiella pneumoniae Bacteraemia Linked to Endoscopic Retrograde Cholangio-Pancreatography. J. Hosp. Infect. 2006;64:S78. doi: 10.1016/S0195-6701(06)60261-2. - DOI
    1. Rauwers A.W., Voor A.F., Buijs J.G., de Groot W., Hansen B.E., Bruno M.J., Vos M.C. High prevalence rate of digestive tract bacteria in duodenoscopes: A nationwide study. Gut. 2018;67:1637–1645. doi: 10.1136/gutjnl-2017-315082. - DOI - PMC - PubMed
    1. Larsen S., Russell R.V., Ockert L.K., Spanos S., Travis H.S., Ehlers L.H., Mærkedahl A. Rate and impact of duodenoscope contamination: A systematic review and meta-analysis. EClinicalMedicine. 2020;25:100451. doi: 10.1016/j.eclinm.2020.100451. - DOI - PMC - PubMed
    1. Infections Associated with Reprocessed Duodenoscopes FDA. [(accessed on 13 April 2023)]; Available online: https://www.fda.gov/medical-devices/reprocessing-reusable-medical-device....

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