Disposable Duodenoscopes: Evidence and Open Issues

Area of Science:

• Gastroenterology and Endoscopic Procedures
• Infectious Disease Control in Healthcare Settings

Background:

• Duodenoscope-related infections pose a significant risk in gastrointestinal (GI) endoscopy, especially for vulnerable patient populations.
• Reusable duodenoscopes have been associated with transmission of multidrug-resistant organisms, necessitating safer alternatives.

Purpose of the Study:

• To evaluate the potential of disposable duodenoscopes in mitigating infection risks during endoscopic retrograde cholangiopancreatography (ERCP).
• To identify patient groups and clinical scenarios where single-use duodenoscopes may be most beneficial.
• To highlight the need for further comparative studies on safety, efficacy, and economics.

Main Methods:

• Review of existing studies on the safety and efficacy of disposable duodenoscopes in ERCP.
• Analysis of the current market introduction stage and economic implications.
• Consideration of environmental impact and comparison with reusable scopes.

Main Results:

• Disposable duodenoscopes show promise for reducing infection transmission, especially in patients with comorbidities or carrying multidrug-resistant bacteria.
• Their use is considered beneficial in urgent endoscopy settings where infection risk is unclear.
• Existing studies support their safety and efficacy, but large-scale randomized trials comparing them to reusable scopes are lacking.

Conclusions:

• Disposable duodenoscopes are a viable option for specific patient groups and situations to minimize infection risks.
• Further robust economic and safety evaluations, including comparisons with cap-disposable models, are essential.
• Definitive guidelines are required for optimal patient selection, and a complete transition to single-use scopes faces current challenges and requires more extensive research.