Frontiers in pediatrics · 2026
Single pediatric center experience with single-use duodenoscopes.
СтатьяНазвание и аннотация: Перевод пока не подготовлен
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Khemka Sapna, Morris Micah, Winkie Colin, Khan Muhammad A
Аннотация
BACKGROUND: Endoscopic retrograde cholangiopancreatography (ERCP) is a key diagnostic and therapeutic tool for hepato-pancreato-biliary conditions. Although widely performed in adults, ERCP in pediatric populations is less common and poses unique challenges, particularly concerning infection control. Reusable duodenoscopes have been linked to patient-to-patient transmission of multidrug-resistant organisms (MDROs), leading to increased interest in single-use duodenoscopes. This study describes the initial experience using single-use duodenoscopes in ERCP at a single pediatric quaternary care center.
METHODS: A retrospective chart review was conducted on all patients who underwent ERCP with the EXALT™ Model D single-use duodenoscope at a single pediatric center from November 1, 2022, to April 15, 2025. Demographics, procedural details, ERCP complexity scores, and post-procedure complications were collected. Descriptive statistics were used for analysis.
RESULTS: Twenty-eight patients (mean age 16 years; 64% female) underwent ERCP with a single-use duodenoscope. Biliary cannulation was successful in 100% of cases. Most procedures were ASGE grade 1 or 2. Stone extraction was performed in 27 cases, stent removal in 25, and new stent placement in 3. Complications occurred in 4 patients (14%): abdominal pain (n = 2), post-ERCP pancreatitis (n = 1), and cholangitis (n = 1), with no cases of post-procedure bleeding or MDRO infections. No procedures required conversion to reusable duodenoscopes.
CONCLUSIONS: Single-use duodenoscopes were effective and safe for ERCP in a pediatric cohort, achieving high technical success and low complication rates. While more studies are needed, particularly in younger or smaller patients and at higher ASGE grades (3 and 4), single-use duodenoscopes may offer a promising alternative to reusable devices, especially in reducing infection risk and simplifying scope maintenance. Broader adoption may depend on the development of pediatric-specific devices and cost-benefit analyses in varying clinical settings.
METHODS: A retrospective chart review was conducted on all patients who underwent ERCP with the EXALT™ Model D single-use duodenoscope at a single pediatric center from November 1, 2022, to April 15, 2025. Demographics, procedural details, ERCP complexity scores, and post-procedure complications were collected. Descriptive statistics were used for analysis.
RESULTS: Twenty-eight patients (mean age 16 years; 64% female) underwent ERCP with a single-use duodenoscope. Biliary cannulation was successful in 100% of cases. Most procedures were ASGE grade 1 or 2. Stone extraction was performed in 27 cases, stent removal in 25, and new stent placement in 3. Complications occurred in 4 patients (14%): abdominal pain (n = 2), post-ERCP pancreatitis (n = 1), and cholangitis (n = 1), with no cases of post-procedure bleeding or MDRO infections. No procedures required conversion to reusable duodenoscopes.
CONCLUSIONS: Single-use duodenoscopes were effective and safe for ERCP in a pediatric cohort, achieving high technical success and low complication rates. While more studies are needed, particularly in younger or smaller patients and at higher ASGE grades (3 and 4), single-use duodenoscopes may offer a promising alternative to reusable devices, especially in reducing infection risk and simplifying scope maintenance. Broader adoption may depend on the development of pediatric-specific devices and cost-benefit analyses in varying clinical settings.