Disposable Duodenoscopes: Evidence and Open Issues

Duodenoscope-related infections are a major concern in medicine and GI endoscopy, especially in fragile patients. Disposable duodenoscopes seem to be the right tool to minimize the problem: a good choice for patients with many comorbidities or with a high risk of carrying multidrug resistant bacteri...

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Bibliographic Details
Published in:Life (Basel, Switzerland) Switzerland), 2023-08, Vol.13 (8), p.1694
Main Authors: Conti, Clara Benedetta, Cereatti, Fabrizio, Salerno, Raffaele, Grassia, Roberto, Scaravaglio, Miki, Laurenza, Carmen, Dinelli, Marco Emilio
Format: Article
Language:English
Subjects:
Antibiotics
Bacterial infections
Bile
cap disposable duodenoscopes
Cholangitis
Climate change
Clinical trials
Cohort analysis
Colposcopes
Comorbidity
COVID-19
Cross infection
Disease prevention
Disease transmission
Drug resistance in microorganisms
economic impact
Endoscopes
endoscopic retrograde cholangiopancreatography
Endoscopy
Environmental impact
Gastroscopes
Health risks
Infections
Medical research
Medical supplies, Disposable
Medicine, Experimental
Mortality
Multidrug resistance
Multidrug resistant organisms
Nosocomial infections
Pandemics
Patients
Process controls
Review
Risk factors
Safety
single-use duodenoscopes
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Summary:Duodenoscope-related infections are a major concern in medicine and GI endoscopy, especially in fragile patients. Disposable duodenoscopes seem to be the right tool to minimize the problem: a good choice for patients with many comorbidities or with a high risk of carrying multidrug resistant bacteria. Urgent endoscopy could also be a good setting for the use of single-use duodenoscopes, especially when the risk of the infection cannot be evaluated. Their safety and efficacy in performing ERCP has been proven in many studies. However, randomized clinical trials and comparative large studies with reusable scopes are lacking. Moreover, the present early stage of their introduction on the market does not allow a large economical evaluation for each health system. Thus, accurate economical and safety comparisons with cap-disposable duodenoscopes are needed. Moreover, the environmental impact of single-use duodenoscopes should be carefully evaluated, considering the ongoing climate change. In conclusion, definitive guidelines are needed to choose wisely the appropriate patients for ERCP with disposable duodenoscopes as the complete switch to single-use duodenoscopes seems to be difficult, to date. Many issues are still open, and they need to be carefully evaluated in further, larger studies.
ISSN:2075-1729
2075-1729
DOI:10.3390/life13081694