The outcomes and safety of patients undergoing endoscopic retrograde cholangiopancreatography combining a single-use cholangioscope and a single-use duodenoscope:A multicenter retrospective international study

作     者：Alessandro Fugazza Matteo Colombo Michel Kahaleh V.Raman Muthusamy Bick Benjamin Wim Laleman Carmelo Barbera Carlo Fabbri Jose Nieto Abed Al-Lehibi Mohan Ramchandani Amy Tyberg Haroon Shahid Avik Sarkar Dean Ehrlich Stuart Shermand Cecilia Binda Marco Spadaccini Andrea Iannone Kareem Khalaf Nageshwar Reddy Andrea Anderloni Alessandro Repici Alessandro Fugazza;Matteo Colombo;Michel Kahaleh;V.Raman Muthusamy;Bick Benjamin;Wim Laleman;Carmelo Barbera;Carlo Fabbri;Jose Nieto;Abed Al-Lehibi;Mohan Ramchandani;Amy Tyberg;Haroon Shahid;Avik Sarkar;Dean Ehrlich;Stuart Sherman;Cecilia Binda;Marco Spadaccini;Andrea Iannone;Kareem Khalaf;Nageshwar Reddy;Andrea Anderloni;Alessandro Repici

作者机构：Division of Gastroenterology and Digestive EndoscopyHumanitas Research Hospital-IRCCSVia Manzoni 5620089RozzanoMilanoItaly GastroenterologyRutgers Robert Wood JohnsonNew BrunswickNew JerseyUSA Vatche and Tamar Manoukian Division of Digestive DiseasesUniversity of CaliforniaLos Angeles School of Medicine at UCLALos AngelesCaliforniaUSA Division of Digestive and Liver DisordersIndiana University School of MedicineIndianapolisINUSA Department of Gastroenterology and HepatologyUniversity Hospitals LeuvenKU Leuven3000 LeuvenBelgium U.O.C.di Gastroenterologia ed Endoscopia DigestivaOspedale Giuseppe MazziniASL TeramoItaly Gastroenterology and Digestive Endoscopy UnitForlì-Cesena HospitalsAUSL RomagnaForlì-CesenaItaly Borland Groover ClinicJacksonvilleFloridaUSA Department of Gastroenterology and HepatologyKing Fahad Medical CityRiyadhSaudi Arabia Asian Institute of GastroenterologyHyderabadIndia Section of GastroenterologyDepartment of Emergency and Organ TransplantationUniversity of BariBari 70124Italy Department of Biomedical SciencesHumanitas UniversityVia Rita Levi Montalcini 420090Pieve EmanueleMilanItaly 

出 版 物：《Hepatobiliary & Pancreatic Diseases International》 (国际肝胆胰疾病杂志（英文版）)

年 卷 期：2024年第23卷第1期

页      面：71-76页

核心收录：

学科分类：1002[医学-临床医学] 100210[医学-外科学(含：普外、骨外、泌尿外、胸心外、神外、整形、烧伤、野战外)] 10[医学] 

主　　题：Single-operator cholangioscopy Single-use duodenoscope Endoscopic retrograde cholangiopancreatography Indeterminate biliary stricture Difficult biliary stones 

摘      要：Background: Duodenoscope-related multidrug-resistant organism(MDRO) infections raise concerns. Disposable duodenoscopes have been recently introduced in the market and approved by regulatory agencies with the aim to reduce the risk of endoscopic retrograde cholangiopancreatography(ERCP) associated infections. The aim of this study was to evaluate the outcome of procedures performed with single-use duodenoscopes in patients with clinical indications to single-operator cholangiopancreatoscopy. Methods: This is a multicenter international, retrospective study combining all patients who underwent complex biliopancreatic interventions using the combination of a single-use duodenoscope and a single-use cholangioscope. The primary outcome was technical success defined as ERCP completion for the intended clinical indication. Secondary outcomes were procedural duration, rate of cross-over to reusable duodenoscope, operator-reported satisfaction score(1 to 10) on performance rating of the single-use duodenoscope, and adverse event(AE) rate. Results: A total of 66 patients(26, 39.4% female) were included in the study. ERCP was categorized according to ASGE ERCP grading system as 47(71.2%) grade 3 and 19(28.8%) grade 4. The technical success rate was 98.5%(65/66). Procedural duration was 64(interquartile range 15-189) min, cross-over rate to reusable duodenoscope was 1/66(1.5%). The satisfaction score of the single-use duodenoscope classified by the operators was 8.6 ± 1.3 points. Four patients(6.1%) experienced AEs not directly related to the single-use duodenoscope, namely 2 post-ERCP pancreatitis(PEP), 1 cholangitis and 1 ***: Single-use duodenoscope is effective, reliable and safe even in technically challenging procedures with a non-inferiority to reusable duodenoscope, making these devices a viable alternative to standard reusable equipment.