PMID- 38250162
OWN - NLM
STAT- PubMed-not-MEDLINE
LR  - 20240123
IS  - 2364-3722 (Print)
IS  - 2196-9736 (Electronic)
IS  - 2196-9736 (Linking)
VI  - 12
IP  - 1
DP  - 2024 Jan
TI  - Urgent ERCP performed with single-use duodenoscope (SUD) in patients with 
      moderate-to-severe cholangitis: Single-center prospective study.
PG  - E116-E122
LID - 10.1055/a-2219-0826 [doi]
AB  - Background and study aims To assess the outcomes of urgent endoscopic retrograde 
      cholangiopancreatography (ERCP) performed with a single-use duodenoscope (SUD) in 
      patients with moderate-to-severe cholangitis. Patients and methods Between 2021 
      and 2022 consecutive patients with moderate-to-severe cholangitis were 
      prospectively enrolled to undergo urgent ERCP with SUD. Technical success was 
      defined as the completion of the planned procedure with SUD. Multivariate 
      analysis was used to identify factors related to incidence of adverse events 
      (AEs) and mortality. Results Thirty-five consecutive patients (15 female, age 
      81.4+/-6.7 years) were enrolled. Twelve (34.3%) had severe cholangitis; 26 (74.3%) 
      had an American Society of Anesthesiologists (ASA) score >/=3. Twenty-eight 
      patients (80.0%) had a naive papilla. Biliary sphincterotomy and complete stone 
      clearance were performed in 29 (82.9%) and 30 patients (85.7%), respectively; in 
      three cases (8.6%), concomitant endoscopic ultrasound-gallbladder drainage was 
      performed. Technical and clinical success rates were 100%. Thirty-day and 3-month 
      mortality were 2.9% and 14.3%, respectively. One patient had mild post-ERCP 
      pancreatitis and two had delayed bleeding. No patient or procedural variables 
      were related to AEs. ASA score 4 and leucopenia were related to 3-month 
      mortality; on multivariate analysis, leukopenia was the only variable 
      independently related to 3-month mortality (odds ratio 12.8; 95% confidence 
      interval 1.03-157.2; P =0.03). Conclusions The results of this "proof of concept" 
      study suggest that SUD use could be considered safe and effective for urgent ERCP 
      for acute cholangitis. This approach abolishes duodenoscope contamination from 
      infected patients without impairing clinical outcomes.
CI  - The Author(s). This is an open access article published by Thieme under the terms 
      of the Creative Commons Attribution-NonDerivative-NonCommercial-License, 
      permitting copying and reproduction so long as the original work is given 
      appropriate credit. Contents may not be used for commercial purposes, or adapted, 
      remixed, transformed or built upon. 
      (https://creativecommons.org/licenses/by-nc-nd/4.0/).
FAU - Masciangelo, Graziella
AU  - Masciangelo G
AD  - Gastroenterology Unit, Hospital of Imola, University of Bologna, Imola, Italy. 
      RINGGOLD: 9296
FAU - Cecinato, Paolo
AU  - Cecinato P
AUID- ORCID: 0000-0002-1870-5952
AD  - Gastroenterology and Endoscopy Unit, Arcispedale Santa Maria Nuova di Reggio 
      Emilia, Reggio Emilia, Italy. RINGGOLD: 9260
FAU - Bacchilega, Igor
AU  - Bacchilega I
AD  - Gastroenterology Unit, Hospital of Imola, University of Bologna, Imola, Italy. 
      RINGGOLD: 9296
FAU - Masetti, Michele
AU  - Masetti M
AD  - Gastroenterology Unit, Hospital of Imola, University of Bologna, Imola, Italy. 
      RINGGOLD: 9296
FAU - Ferrari, Rodolfo
AU  - Ferrari R
AD  - Gastroenterology Unit, Hospital of Imola, University of Bologna, Imola, Italy. 
      RINGGOLD: 9296
FAU - Zagari, Rocco Maurizio
AU  - Zagari RM
AUID- ORCID: 0000-0001-9949-8619
AD  - Department of Medical and Surgical Sciences, University of Bologna, Bologna, 
      Italy. RINGGOLD: 9296
FAU - Napoleon, Bertrand
AU  - Napoleon B
AD  - Endoscopy Unit, Centre Chirurgical Lyon Mermoz, Lyon, France. RINGGOLD: 89686
FAU - Sassatelli, Romano
AU  - Sassatelli R
AD  - Gastroenterology and Endoscopy Unit, Arcispedale Santa Maria Nuova di Reggio 
      Emilia, Reggio Emilia, Italy. RINGGOLD: 9260
FAU - Fusaroli, Pietro
AU  - Fusaroli P
AUID- ORCID: 0000-0002-4397-9314
AD  - Gastroenterology Unit, Hospital of Imola, University of Bologna, Imola, Italy. 
      RINGGOLD: 9296
FAU - Lisotti, Andrea
AU  - Lisotti A
AUID- ORCID: 0000-0002-7724-7402
AD  - Gastroenterology Unit, Hospital of Imola, University of Bologna, Imola, Italy. 
      RINGGOLD: 9296
LA  - eng
PT  - Journal Article
DEP - 20240119
PL  - Germany
TA  - Endosc Int Open
JT  - Endoscopy international open
JID - 101639919
PMC - PMC10798844
OTO - NOTNLM
OT  - Cholangioscopy
OT  - Hygiene
OT  - Quality and logistical aspects
OT  - Stones
COIS- Conflict of Interest Bertrand Napoleon received research grant and teaching 
      sessions from Boston Scientific Corporation. Pietro Fusaroli received consultancy 
      from Boston Scientific Corporation. Dr. Andrea Lisotti has a contract of 
      proctorship for 2021 and 2022 with Boston Scientific Corporation. All the other 
      Authors have no conflict of interest to declare.
EDAT- 2024/01/22 06:43
MHDA- 2024/01/22 06:44
PMCR- 2024/01/01
CRDT- 2024/01/22 05:14
PHST- 2023/08/25 00:00 [received]
PHST- 2023/11/10 00:00 [accepted]
PHST- 2024/01/22 06:44 [medline]
PHST- 2024/01/22 06:43 [pubmed]
PHST- 2024/01/22 05:14 [entrez]
PHST- 2024/01/01 00:00 [pmc-release]
AID - EIO-2023-08-3112-OA [pii]
AID - 10.1055/a-2219-0826 [doi]
PST - epublish
SO  - Endosc Int Open. 2024 Jan 19;12(1):E116-E122. doi: 10.1055/a-2219-0826. 
      eCollection 2024 Jan.