Single-use duodenoscope for ERCP performed by endoscopists with a range of experience in procedures of variable complexity

Expert endoscopists previously reported ERCP outcomes for the first commercialized single-use duodenoscope. We aimed to document usability of this device by endoscopists with different levels of ERCP experience. Fourteen “expert” (>2000 lifetime ERCPs) and 5 “less-expert” endoscopists performed c...

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Veröffentlicht in:Gastrointestinal endoscopy 2021-12, Vol.94 (6), p.1046-1055
Hauptverfasser: Slivka, Adam, Ross, Andrew S., Sejpal, Divyesh V., Petersen, Bret T., Bruno, Marco J., Pleskow, Douglas K., Muthusamy, V. Raman, Chennat, Jennifer S., Krishnamoorthi, Rajesh, Lee, Calvin, Martin, John A., Poley, Jan-Werner, Cohen, Jonah M., Thaker, Adarsh M., Peetermans, Joyce A., Rousseau, Matthew J., Tirrell, Gregory P., Kozarek, Richard A., Khalid, Asif, Das, Rohit, Singh, Harkirat, Vipperla, Kishore, Antony, Andrew, Choi, Jun-Ho, Larsen, Michael, Law, Joanna, Klair, Jagpal, Thaker, Adarsh, Abu Dayyeh, Barham, Chandrasekhara, Vinay, Levy, Michael, Law, Ryan, Insull, Jeff
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container_end_page 1055
container_issue 6
container_start_page 1046
container_title Gastrointestinal endoscopy
container_volume 94
creator Slivka, Adam
Ross, Andrew S.
Sejpal, Divyesh V.
Petersen, Bret T.
Bruno, Marco J.
Pleskow, Douglas K.
Muthusamy, V. Raman
Chennat, Jennifer S.
Krishnamoorthi, Rajesh
Lee, Calvin
Martin, John A.
Poley, Jan-Werner
Cohen, Jonah M.
Thaker, Adarsh M.
Peetermans, Joyce A.
Rousseau, Matthew J.
Tirrell, Gregory P.
Kozarek, Richard A.
Slivka, Adam
Chennat, Jennifer S.
Khalid, Asif
Das, Rohit
Singh, Harkirat
Vipperla, Kishore
Sejpal, Divyesh V.
Lee, Calvin
Antony, Andrew
Kozarek, Richard A.
Ross, Andrew S.
Choi, Jun-Ho
Larsen, Michael
Law, Joanna
Krishnamoorthi, Rajesh
Klair, Jagpal
Muthusamy, V. Raman
Thaker, Adarsh
Petersen, Bret T.
Martin, John A.
Abu Dayyeh, Barham
Chandrasekhara, Vinay
Levy, Michael
Law, Ryan
Pleskow, Douglas K.
Cohen, Jonah M.
Bruno, Marco J.
Poley, Jan-Werner
Peetermans, Joyce A.
Rousseau, Matthew J.
Tirrell, Gregory P.
Insull, Jeff
description Expert endoscopists previously reported ERCP outcomes for the first commercialized single-use duodenoscope. We aimed to document usability of this device by endoscopists with different levels of ERCP experience. Fourteen “expert” (>2000 lifetime ERCPs) and 5 “less-expert” endoscopists performed consecutive ERCPs in patients without altered pancreaticobiliary anatomy. Outcomes included ERCP completion for the intended indication, rate of crossover to another endoscope, device performance ratings, and serious adverse events. Two hundred ERCPs including 81 (40.5%) with high complexity (American Society for Gastrointestinal Endoscopy grades 3-4) were performed. Crossover rate (11.3% vs 2.5%, P = .131), ERCP completion rate (regardless of crossovers) (96.3% vs 97.5%, P = .999), median ERCP completion time (25.0 vs 28.5 minutes, P = .130), mean cannulation attempts (2.8 vs 2.8, P = .954), and median overall satisfaction with the single-use duodenoscope (8.0 vs 8.0 [range, 1.0-10.0], P = .840) were similar for expert versus less-expert endoscopists, respectively. The same metrics were similar by procedural complexity except for shorter median completion time for grades 1 to 2 versus grades 3 to 4 (P < .001). Serious adverse events were reported in 13 patients (6.5%). In consecutive ERCPs including high complexity procedures, endoscopists with varying ERCP experience had good procedural success and reported high device performance ratings. (Clinical trial registration number: NCT04223830.) [Display omitted]
doi_str_mv 10.1016/j.gie.2021.06.017
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Raman ; Chennat, Jennifer S. ; Krishnamoorthi, Rajesh ; Lee, Calvin ; Martin, John A. ; Poley, Jan-Werner ; Cohen, Jonah M. ; Thaker, Adarsh M. ; Peetermans, Joyce A. ; Rousseau, Matthew J. ; Tirrell, Gregory P. ; Kozarek, Richard A. ; Slivka, Adam ; Chennat, Jennifer S. ; Khalid, Asif ; Das, Rohit ; Singh, Harkirat ; Vipperla, Kishore ; Sejpal, Divyesh V. ; Lee, Calvin ; Antony, Andrew ; Kozarek, Richard A. ; Ross, Andrew S. ; Choi, Jun-Ho ; Larsen, Michael ; Law, Joanna ; Krishnamoorthi, Rajesh ; Klair, Jagpal ; Muthusamy, V. Raman ; Thaker, Adarsh ; Petersen, Bret T. ; Martin, John A. ; Abu Dayyeh, Barham ; Chandrasekhara, Vinay ; Levy, Michael ; Law, Ryan ; Pleskow, Douglas K. ; Cohen, Jonah M. ; Bruno, Marco J. ; Poley, Jan-Werner ; Peetermans, Joyce A. ; Rousseau, Matthew J. ; Tirrell, Gregory P. ; Insull, Jeff</creator><creatorcontrib>Slivka, Adam ; Ross, Andrew S. ; Sejpal, Divyesh V. ; Petersen, Bret T. ; Bruno, Marco J. ; Pleskow, Douglas K. ; Muthusamy, V. Raman ; Chennat, Jennifer S. ; Krishnamoorthi, Rajesh ; Lee, Calvin ; Martin, John A. ; Poley, Jan-Werner ; Cohen, Jonah M. ; Thaker, Adarsh M. ; Peetermans, Joyce A. ; Rousseau, Matthew J. ; Tirrell, Gregory P. ; Kozarek, Richard A. ; Slivka, Adam ; Chennat, Jennifer S. ; Khalid, Asif ; Das, Rohit ; Singh, Harkirat ; Vipperla, Kishore ; Sejpal, Divyesh V. ; Lee, Calvin ; Antony, Andrew ; Kozarek, Richard A. ; Ross, Andrew S. ; Choi, Jun-Ho ; Larsen, Michael ; Law, Joanna ; Krishnamoorthi, Rajesh ; Klair, Jagpal ; Muthusamy, V. Raman ; Thaker, Adarsh ; Petersen, Bret T. ; Martin, John A. ; Abu Dayyeh, Barham ; Chandrasekhara, Vinay ; Levy, Michael ; Law, Ryan ; Pleskow, Douglas K. ; Cohen, Jonah M. ; Bruno, Marco J. ; Poley, Jan-Werner ; Peetermans, Joyce A. ; Rousseau, Matthew J. ; Tirrell, Gregory P. ; Insull, Jeff ; EXALT Single-use Duodenoscope Study Group</creatorcontrib><description>Expert endoscopists previously reported ERCP outcomes for the first commercialized single-use duodenoscope. We aimed to document usability of this device by endoscopists with different levels of ERCP experience. Fourteen “expert” (&gt;2000 lifetime ERCPs) and 5 “less-expert” endoscopists performed consecutive ERCPs in patients without altered pancreaticobiliary anatomy. Outcomes included ERCP completion for the intended indication, rate of crossover to another endoscope, device performance ratings, and serious adverse events. Two hundred ERCPs including 81 (40.5%) with high complexity (American Society for Gastrointestinal Endoscopy grades 3-4) were performed. Crossover rate (11.3% vs 2.5%, P = .131), ERCP completion rate (regardless of crossovers) (96.3% vs 97.5%, P = .999), median ERCP completion time (25.0 vs 28.5 minutes, P = .130), mean cannulation attempts (2.8 vs 2.8, P = .954), and median overall satisfaction with the single-use duodenoscope (8.0 vs 8.0 [range, 1.0-10.0], P = .840) were similar for expert versus less-expert endoscopists, respectively. The same metrics were similar by procedural complexity except for shorter median completion time for grades 1 to 2 versus grades 3 to 4 (P &lt; .001). Serious adverse events were reported in 13 patients (6.5%). In consecutive ERCPs including high complexity procedures, endoscopists with varying ERCP experience had good procedural success and reported high device performance ratings. (Clinical trial registration number: NCT04223830.) 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We aimed to document usability of this device by endoscopists with different levels of ERCP experience. Fourteen “expert” (&gt;2000 lifetime ERCPs) and 5 “less-expert” endoscopists performed consecutive ERCPs in patients without altered pancreaticobiliary anatomy. Outcomes included ERCP completion for the intended indication, rate of crossover to another endoscope, device performance ratings, and serious adverse events. Two hundred ERCPs including 81 (40.5%) with high complexity (American Society for Gastrointestinal Endoscopy grades 3-4) were performed. Crossover rate (11.3% vs 2.5%, P = .131), ERCP completion rate (regardless of crossovers) (96.3% vs 97.5%, P = .999), median ERCP completion time (25.0 vs 28.5 minutes, P = .130), mean cannulation attempts (2.8 vs 2.8, P = .954), and median overall satisfaction with the single-use duodenoscope (8.0 vs 8.0 [range, 1.0-10.0], P = .840) were similar for expert versus less-expert endoscopists, respectively. The same metrics were similar by procedural complexity except for shorter median completion time for grades 1 to 2 versus grades 3 to 4 (P &lt; .001). Serious adverse events were reported in 13 patients (6.5%). In consecutive ERCPs including high complexity procedures, endoscopists with varying ERCP experience had good procedural success and reported high device performance ratings. (Clinical trial registration number: NCT04223830.) [Display omitted]</description><subject>Catheterization</subject><subject>Cholangiopancreatography, Endoscopic Retrograde</subject><subject>Duodenoscopes</subject><subject>Endoscopy, Gastrointestinal</subject><subject>Humans</subject><issn>0016-5107</issn><issn>1097-6779</issn><fulltext>true</fulltext><rsrctype>article</rsrctype><creationdate>2021</creationdate><recordtype>article</recordtype><sourceid>EIF</sourceid><recordid>eNo1kc1v1DAQxS0EokvhD-CCfOSSMP6InYgTWpUPqVIrCmfLsSeLV9k42Enb7V-Pty2nGen9NHpvHiHvGdQMmPq0r3cBaw6c1aBqYPoF2TDodKW07l6SDRSoahjoM_Im5z0AtFyw1-RMSNYqaPiGPNyEaTditWakfo0ep5hdnJEOMdGLn9trOmMq-wE97Y8UJ_-oh7xkeheWP9TSZKcd0jhQvC9swMkhDROdU3To14T5pN3aFGw_InXxMI94H5bjW_JqsGPGd8_znPz-evFr-726vPr2Y_vlskKuxFKxVvtOKhyEdVq2JVIvG-tl8S9534D0TT9Yx4XwgquBceYbFAKYBc-E0uKcfHy6Wxz9XTEv5hCyw3G0E8Y1G95I1elWQlfQD8_o2pfEZk7hYNPR_P9XAT4_AVgM3wZMJrvHxD4kdIvxMRgG5tSO2ZvSjjm1Y0CZ0o74B5W9gls</recordid><startdate>202112</startdate><enddate>202112</enddate><creator>Slivka, Adam</creator><creator>Ross, Andrew S.</creator><creator>Sejpal, Divyesh V.</creator><creator>Petersen, Bret T.</creator><creator>Bruno, Marco J.</creator><creator>Pleskow, Douglas K.</creator><creator>Muthusamy, V. 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Raman ; Chennat, Jennifer S. ; Krishnamoorthi, Rajesh ; Lee, Calvin ; Martin, John A. ; Poley, Jan-Werner ; Cohen, Jonah M. ; Thaker, Adarsh M. ; Peetermans, Joyce A. ; Rousseau, Matthew J. ; Tirrell, Gregory P. ; Kozarek, Richard A. ; Slivka, Adam ; Chennat, Jennifer S. ; Khalid, Asif ; Das, Rohit ; Singh, Harkirat ; Vipperla, Kishore ; Sejpal, Divyesh V. ; Lee, Calvin ; Antony, Andrew ; Kozarek, Richard A. ; Ross, Andrew S. ; Choi, Jun-Ho ; Larsen, Michael ; Law, Joanna ; Krishnamoorthi, Rajesh ; Klair, Jagpal ; Muthusamy, V. Raman ; Thaker, Adarsh ; Petersen, Bret T. ; Martin, John A. ; Abu Dayyeh, Barham ; Chandrasekhara, Vinay ; Levy, Michael ; Law, Ryan ; Pleskow, Douglas K. ; Cohen, Jonah M. ; Bruno, Marco J. ; Poley, Jan-Werner ; Peetermans, Joyce A. ; Rousseau, Matthew J. ; Tirrell, Gregory P. ; Insull, Jeff</author></sort><facets><frbrtype>5</frbrtype><frbrgroupid>cdi_FETCH-LOGICAL-e263t-187d946ef3ac748016b45ad460542b504d5bfac233d326f121d5e3301a0d13673</frbrgroupid><rsrctype>articles</rsrctype><prefilter>articles</prefilter><language>eng</language><creationdate>2021</creationdate><topic>Catheterization</topic><topic>Cholangiopancreatography, Endoscopic Retrograde</topic><topic>Duodenoscopes</topic><topic>Endoscopy, Gastrointestinal</topic><topic>Humans</topic><toplevel>peer_reviewed</toplevel><toplevel>online_resources</toplevel><creatorcontrib>Slivka, Adam</creatorcontrib><creatorcontrib>Ross, Andrew S.</creatorcontrib><creatorcontrib>Sejpal, Divyesh V.</creatorcontrib><creatorcontrib>Petersen, Bret T.</creatorcontrib><creatorcontrib>Bruno, Marco J.</creatorcontrib><creatorcontrib>Pleskow, Douglas K.</creatorcontrib><creatorcontrib>Muthusamy, V. 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Raman</au><au>Chennat, Jennifer S.</au><au>Krishnamoorthi, Rajesh</au><au>Lee, Calvin</au><au>Martin, John A.</au><au>Poley, Jan-Werner</au><au>Cohen, Jonah M.</au><au>Thaker, Adarsh M.</au><au>Peetermans, Joyce A.</au><au>Rousseau, Matthew J.</au><au>Tirrell, Gregory P.</au><au>Kozarek, Richard A.</au><au>Slivka, Adam</au><au>Chennat, Jennifer S.</au><au>Khalid, Asif</au><au>Das, Rohit</au><au>Singh, Harkirat</au><au>Vipperla, Kishore</au><au>Sejpal, Divyesh V.</au><au>Lee, Calvin</au><au>Antony, Andrew</au><au>Kozarek, Richard A.</au><au>Ross, Andrew S.</au><au>Choi, Jun-Ho</au><au>Larsen, Michael</au><au>Law, Joanna</au><au>Krishnamoorthi, Rajesh</au><au>Klair, Jagpal</au><au>Muthusamy, V. Raman</au><au>Thaker, Adarsh</au><au>Petersen, Bret T.</au><au>Martin, John A.</au><au>Abu Dayyeh, Barham</au><au>Chandrasekhara, Vinay</au><au>Levy, Michael</au><au>Law, Ryan</au><au>Pleskow, Douglas K.</au><au>Cohen, Jonah M.</au><au>Bruno, Marco J.</au><au>Poley, Jan-Werner</au><au>Peetermans, Joyce A.</au><au>Rousseau, Matthew J.</au><au>Tirrell, Gregory P.</au><au>Insull, Jeff</au><aucorp>EXALT Single-use Duodenoscope Study Group</aucorp><format>journal</format><genre>article</genre><ristype>JOUR</ristype><atitle>Single-use duodenoscope for ERCP performed by endoscopists with a range of experience in procedures of variable complexity</atitle><jtitle>Gastrointestinal endoscopy</jtitle><addtitle>Gastrointest Endosc</addtitle><date>2021-12</date><risdate>2021</risdate><volume>94</volume><issue>6</issue><spage>1046</spage><epage>1055</epage><pages>1046-1055</pages><issn>0016-5107</issn><eissn>1097-6779</eissn><abstract>Expert endoscopists previously reported ERCP outcomes for the first commercialized single-use duodenoscope. We aimed to document usability of this device by endoscopists with different levels of ERCP experience. Fourteen “expert” (&gt;2000 lifetime ERCPs) and 5 “less-expert” endoscopists performed consecutive ERCPs in patients without altered pancreaticobiliary anatomy. Outcomes included ERCP completion for the intended indication, rate of crossover to another endoscope, device performance ratings, and serious adverse events. Two hundred ERCPs including 81 (40.5%) with high complexity (American Society for Gastrointestinal Endoscopy grades 3-4) were performed. Crossover rate (11.3% vs 2.5%, P = .131), ERCP completion rate (regardless of crossovers) (96.3% vs 97.5%, P = .999), median ERCP completion time (25.0 vs 28.5 minutes, P = .130), mean cannulation attempts (2.8 vs 2.8, P = .954), and median overall satisfaction with the single-use duodenoscope (8.0 vs 8.0 [range, 1.0-10.0], P = .840) were similar for expert versus less-expert endoscopists, respectively. The same metrics were similar by procedural complexity except for shorter median completion time for grades 1 to 2 versus grades 3 to 4 (P &lt; .001). Serious adverse events were reported in 13 patients (6.5%). In consecutive ERCPs including high complexity procedures, endoscopists with varying ERCP experience had good procedural success and reported high device performance ratings. (Clinical trial registration number: NCT04223830.) [Display omitted]</abstract><cop>United States</cop><pub>Elsevier Inc</pub><pmid>34186052</pmid><doi>10.1016/j.gie.2021.06.017</doi><tpages>10</tpages><oa>free_for_read</oa></addata></record>
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identifier ISSN: 0016-5107
ispartof Gastrointestinal endoscopy, 2021-12, Vol.94 (6), p.1046-1055
issn 0016-5107
1097-6779
language eng
recordid cdi_proquest_miscellaneous_2546978409
source MEDLINE; Elsevier ScienceDirect Journals
subjects Catheterization
Cholangiopancreatography, Endoscopic Retrograde
Duodenoscopes
Endoscopy, Gastrointestinal
Humans
title Single-use duodenoscope for ERCP performed by endoscopists with a range of experience in procedures of variable complexity
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