Initial experience with duodenoscopes with single-use end caps in pediatric ERCP: infection prevention comes at a cost

Gastrointest Endosc. 2024 Aug;100(2):312-316. doi: 10.1016/j.gie.2024.03.009. Epub 2024 Mar 8.

Abstract

Background and aims: Duodenoscopes with single-use end caps were introduced to minimize infection risk, but they are unstudied in pediatrics.

Methods: We collected clinical data and endoscopists' evaluations of duodenoscopes with single-use end caps versus reusable duodenoscopes over 18 months.

Results: A total of 106 ERCPs were performed for patients aged 1 to 18 (mean, 14.2) years. Forty-six involved single-use end caps, with 9 requiring crossover to reusable duodenoscopes. ERCPs involving single-use end caps resulted in more instances of mucosal trauma (10 vs 0; P < .05) and post-ERCP pancreatitis (4 vs 1; P < .05) and accounted for 8 of 9 ERCPs requiring advanced cannulation techniques. No post-ERCP infections occurred. Reported challenges included single-use end cap stiffness and difficulty with their alignment for cannulation.

Conclusions: We report difficulty with advancement, greater reliance on advanced cannulation techniques, and higher rates of post-ERCP pancreatitis when using duodenoscopes with single-use end caps in pediatric ERCP. This area warrants further study.

MeSH terms

  • Adolescent
  • Catheterization
  • Child
  • Child, Preschool
  • Cholangiopancreatography, Endoscopic Retrograde* / adverse effects
  • Disposable Equipment / economics
  • Duodenoscopes* / microbiology
  • Equipment Design
  • Equipment Reuse / economics
  • Female
  • Humans
  • Infant
  • Male
  • Pancreatitis / etiology
  • Pancreatitis / prevention & control
  • Retrospective Studies