Single-use duodenoscopes for the prevention of endoscopic retrograde cholangiopancreatography -related cross-infection – from bench studies to clinical evidence

查看全文 作　　者：Andrea [1]Lisotti;Pietro [1]Fusaroli;Bertrand [2]Napoleon;Anna [1]Cominardi;Rocco Maurizio [3]Zagari 机构地区：[1]Gastroenterology Unit,Hospital of Imola,University of Bologna,Imola 40026,BO,Italy;[2]Gastroenterology Unit,Hôpital privéJean Mermoz-Ramsay Générale de Santé,Lyon 69008,FR,France;[3]Dipertimento Di Scienze Mediche e Chirurgiche,Universitàdi Bologna,Policlinico San Orsola Malpighi,Bologna 40138,Italy 出　　处：《World Journal of Methodology》索引2022年第12卷第3期,共10页 摘　　要：BACKGROUND Several strategies have been implemented to reduce or abolish the life-threatening risk of endoscopic retrograde cholangiopancreatography(ERCP)-related multidrug-resistant infections due to duodenoscopes contaminations;among those strategies,serial microbiologic tests,thorough reprocessing schedules,and use of removable scope cap have been adopted,but the potential cross-infection risk was not eliminated.AIM To review available evidence in the field of single-use duodenoscopes(SUD)use for ERCP.METHODS An overview on ongoing clinical studies was also performed to delineate which data will become available in the next future.RESULTS One bench comparative study and four clinical trials performed with EXALT model-D(Boston Scientific Corp.,United States)have been identified.Of them,one is a randomized controlled trial,while the other three studies are prospective single-arm,cross-over studies.Pooled technical success rate(4 studies,368 patients)was 92.9%[95%confidence interval(CI):89.9-95.5;I2:11.8%].Pooled serious adverse event(4 studies,381 patients)rate was 5.9%[3.7%-8.5%;I2:0.0%].CONCLUSION Although few clinical trials are available,evidence is concordant in identifying an absolute feasibility and safety and feasibility for SUD use for ERCP.The expertise and quality of evidence in this field are going to be improved by further large clinical trials;data on cost-effectiveness and environmental impact will be needed for a worldwide spread of SUD use for ERCP. 关 键 词：MULTIDRUG Resistance CONTAMINATION INFECTION REPROCESSING Guidelines