First Single-Use Duodenoscope Measures up in Direct Comparison for Low-Complexity Procedures
Bret T. Petersen, MD, MASGE, reviewing Bang JY, et al. Gut 2020 Sep 7.
The development of single-use (disposable) endoscopes is one approach to eliminating infection transmission between sequential patients during endoscopy. This single-center study randomized patients undergoing endoscopic retrograde cholangiopancreatography (ERCP) to a traditional reusable instrument or the single-use Exalt Model D duodenoscope (Boston Scientific Corp, Marlborough, Massachusetts). Among 98 predominantly (>80%) low-complexity procedures in 98 patients (50 reusable, 48 single use), the rates for cannulation success, adverse events, cross-over, or use of ancillary cannulation techniques did not differ between instruments, but the median number of cannulation attempts was significantly lower with the single-use instrument (P=.013). Following adjustment for patient and procedural characteristics, only the instrument type correlated with <6 attempts to achieve cannulation on multivariate analysis (P=.012). In contrast, the single-use instrument was graded “significantly worse” for image quality (P<.001) and stability (P<.001), ease of passage to the stomach (P=.047), and function of the air–water button (P<.001).
Note to readers: At the time we reviewed this paper, its publisher noted that it was not in final form and that subsequent changes might be made.
Bang JY, Hawes R, Varadarajulu S. Equivalent performance of single-use and reusable duodenoscopes in a randomised trial. Gut 2020 Sep 7. (Epub ahead of print) (http://dx.doi.org/10.1136/gutjnl-2020-321836)