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

Monique T Barakat1, Andrew Liman2, Roberto Gugig2

  • 1Division of Pediatric Gastroenterology and Hepatology, Department of Pediatrics, Lucile Packard Children's Hospital at Stanford University School of Medicine, Palo Alto, California, USA; Division of Gastroenterology and Hepatology, Department of Internal Medicine, Stanford University School of Medicine, Stanford, California, USA.

Gastrointestinal Endoscopy
|March 10, 2024
PubMed

Insights

Single-use end caps on duodenoscopes may increase risks for pediatric patients undergoing ERCP, causing more trauma and pancreatitis. Further research is needed for these devices in pediatric endoscopy.

Area of Science:

  • Gastroenterology
  • Pediatric Endoscopy
  • Infection Control

Background:

  • Single-use end caps for duodenoscopes were developed to reduce infection transmission.
  • Their safety and efficacy in pediatric patients remain uninvestigated.

Purpose of the Study:

  • To evaluate the clinical outcomes and procedural challenges of using duodenoscopes with single-use end caps in pediatric patients.

Main Methods:

  • A retrospective review of 106 ERCP procedures in patients aged 1-18 years.
  • Comparison of outcomes between duodenoscopes with single-use end caps and reusable duodenoscopes.

Main Results:

  • Procedures with single-use end caps showed increased mucosal trauma (10 vs 0) and post-ERCP pancreatitis (4 vs 1).
  • Greater use of advanced cannulation techniques was noted with single-use end caps.
  • No post-ERCP infections were reported, but challenges included cap stiffness and alignment issues.

Conclusions:

  • Duodenoscopes with single-use end caps present challenges in pediatric ERCP, including advancement difficulties and increased pancreatitis rates.
  • These findings suggest a need for further investigation into the use of single-use end caps in pediatric populations.
Abstract

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