Single pediatric center experience with single-use duodenoscopes.

Area of Science:

• Gastroenterology
• Pediatric Endoscopy
• Infection Control

Background:

• Endoscopic retrograde cholangiopancreatography (ERCP) is vital for hepato-pancreato-biliary conditions.
• Pediatric ERCP presents unique infection control challenges, with reusable duodenoscopes linked to multidrug-resistant organism (MDRO) transmission.
• Single-use duodenoscopes are emerging as a potential solution to mitigate infection risks.

Purpose of the Study:

• To evaluate the initial experience and safety of single-use duodenoscopes in pediatric ERCP.
• To assess technical success rates and complication profiles associated with single-use duodenoscopes in a pediatric population.

Main Methods:

• Retrospective chart review of pediatric patients undergoing ERCP with a single-use duodenoscope (EXALT™ Model D).
• Data collected included demographics, procedural details, ERCP complexity scores, and post-procedure complications.
• Descriptive statistics were employed for data analysis.

Main Results:

• Twenty-eight pediatric patients (mean age 16) underwent ERCP with single-use duodenoscopes.
• 100% technical success for biliary cannulation was achieved, with most procedures being ASGE grade 1 or 2.
• A 14% complication rate was observed (abdominal pain, pancreatitis, cholangitis), with no MDRO infections or post-procedure bleeding.

Conclusions:

• Single-use duodenoscopes are effective and safe for pediatric ERCP, demonstrating high success and low complication rates.
• They present a promising alternative to reusable duodenoscopes, particularly for reducing infection transmission and simplifying scope management.
• Further research is needed for younger patients and higher ASGE grades, alongside cost-benefit analyses for broader adoption.