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https://www.readbyqxmd.com/read/28241955/clinical-issues-march-2017
#1
Sharon A Van Wicklin
Using one flexible endoscope for an upper and lower gastrointestinal (GI) endoscopy procedure Key words: flexible endoscope, esophagogastroduodenoscopy, colonoscopy, enteroscope, risk assessment. Enhanced methods for processing flexible duodenoscopes Key words: flexible duodenoscopes, liquid chemical sterilization, ethylene oxide sterilization, low-temperature sterilization, risk assessment. Modification of the Spaulding classification Key words: Spaulding classification, critical items, semicritical items, mucous membranes, risk assessment...
March 2017: AORN Journal
https://www.readbyqxmd.com/read/28188033/success-and-safety-of-endoscopic-retrograde-cholangiopancreatography-in-children
#2
Jordan D Rosen, Rebecca S Lane, Jose M Martinez, Eduardo A Perez, Jun Tashiro, Amy E Wagenaar, Robert M Van Haren, Ashwini Kumar, Juan E Sola
PURPOSE: Despite its diagnostic and therapeutic utility, endoscopic retrograde cholangiopancreatography (ERCP) is underutilized in children. METHODS: Patients younger than 18years undergoing ERCP from 2000 to 2014 at a children's hospital were identified. Patient characteristics and outcomes were evaluated. RESULTS: Overall, 215 ERCPs (78% therapeutic) were performed in 184 patients. Our cohort was 67% female, with a median age (IQR) of 14 (8) years...
February 1, 2017: Journal of Pediatric Surgery
https://www.readbyqxmd.com/read/28179089/a-snare-assisted-peroral-direct-choledochoscopy-and-pancreatoscopy-using-an-ultra-slim-upper-endoscope-a-case-series-study
#3
Yong-Hui Huang, Hong Chang, Wei Yao, Yao-Peng Zhang, Ke Li, Ye Wang
OBJECTIVE: To evaluate the feasibility, effectiveness and safety of a new snare-assisted peroral direct choledochoscopy/pancreatoscopy (PDCPS) technique. METHODS: From November 2014 through December 2016, 20 consecutive patients with indications for PDCPS were enrolled in this observational study. Endoscopic retrograde cholangiography was initially performed using a conventional duodenoscope, and endoscopic papillary balloon dilation was performed. Next, an ultra-slim endoscope was inserted to perform the PDCPS; a snare tightened around the end of the scope's bending section facilitated its entry into the common bile duct (CBD)...
January 20, 2017: Digestive and Liver Disease
https://www.readbyqxmd.com/read/28176466/safety-and-efficacy-of-a-novel-continuous-incision-technique-for-laparoscopic-transcystic-choledocholithotomy
#4
Tetsuya Otani, Naoyuki Yokoyama, Daisuke Sato, Kazuaki Kobayashi, Akira Iwaya, Shirou Kuwabara, Toshiyuki Yamazaki, Natsumi Matsuzawa, Hideki Saito, Norio Katayanagi
INTRODUCTION: The purpose of this study was to evaluate the safety and efficacy of a novel continuous incision technique for the cystic duct and the bile duct over the orifice for laparoscopic transcystic choledocholithotomy (LTCL). METHODS: LTCL was attempted in 103 consecutive patients from January 1998 to March 2015 and was successful in 96 patients. The cystic duct confluence was made by cutting upward from the orifice in 19 patients. The cystic duct was incised downward beyond the orifice to the bile duct in the other 77 patients...
February 8, 2017: Asian Journal of Endoscopic Surgery
https://www.readbyqxmd.com/read/28134720/multidepartmental-response-to-a-duodenoscope-used-on-a-cre-patient-a-case-study
#5
Mark A Bruns, Elizabeth R Gibbs
Transmission of carbapenem-resistant Enterobacteriaceae (CRE) via duodenoscopes, specialized endoscopes used during endoscopic retrograde cholangiopancreatography (ERCP) procedures, has attracted media attention since early 2015. This attention has placed increasing focus on the reprocessing of duodenoscopes. Current reprocessing recommendations for these endoscopes require either high-level disinfection or ethylene oxide sterilization. While reprocessing duodenoscopes, staff at endoscopy locations within the Mercy health system perform a single high-level disinfection cycle that is preceded by two cycles of manual cleaning...
January 2017: Gastroenterology Nursing: the Official Journal of the Society of Gastroenterology Nurses and Associates
https://www.readbyqxmd.com/read/28034537/duodenoscope-hang-time-does-not-correlate-with-risk-of-bacterial-contamination
#6
Riley Heroux, Michelle Sheppard, Sharon B Wright, Mandeep Sawhney, Elizabeth B Hirsch, Robin Kalaidjian, Graham M Snyder
BACKGROUND: Current professional guidelines recommend a maximum hang time for reprocessed duodenoscopes of 5-14 days. We sought to study the association between hang time and risk of duodenoscope contamination. METHODS: We analyzed cultures of the elevator mechanism and working channel collected in a highly standardized fashion just before duodenoscope use. Hang time was calculated as the time from reprocessing to duodenoscope sampling. The relationship between hang time and duodenoscope contamination was estimated using a calculated correlation coefficient between hang time in days and degree of contamination on the elevator mechanism and working channel...
December 26, 2016: American Journal of Infection Control
https://www.readbyqxmd.com/read/28033284/endoscopic-retrograde-cholangiopancreatography-in-patients-with-surgically-altered-anatomy-one-single-center-s-experience
#7
Fei Wang, Boming Xu, Quanpeng Li, Xiuhua Zhang, Guobing Jiang, Xianxiu Ge, Junjie Nie, Xiuyun Zhang, Ping Wu, Jie Ji, Lin Miao
Endoscopic retrograde cholangiopancreatography (ERCP) in patients with surgically altered anatomy is challenging. Results of ERCP in those patients varied.The aim of our study was to evaluate the safety and effectiveness of various endoscopes-assisted ERCP in patients with surgically altered anatomy.Fifty-two patients with Billroth II reconstruction (group A), 20 patients with subtotal or total gastrectomy with Roux-en-Y anastomosis (group B), 25 patients with pancreatoduodenectomy or Roux-en-Y hepaticojejunostomy reconstruction (group C) were included...
December 2016: Medicine (Baltimore)
https://www.readbyqxmd.com/read/27922516/advances-in-endoscope-reprocessing-technology-and-its-impact-on-pathogen-transmission
#8
Cathleen Shellnutt
Pathogen transmissions via flexible endoscopes have been documented in the literature and have been historically related to human error or omission of steps in the reprocessing cycle. The 2008 Centers for Disease Control and Prevention report challenged manufacturers of automated endoscope reprocessors to improve and advance technology to automate more of the reprocessing steps. A review and synthesis of the literature following the 2008 Centers for Disease Control and Prevention report was performed to evaluate whether advances in reprocessing technology have occurred and whether these have had an impact on pathogen transmission via flexible endoscopes...
November 2016: Gastroenterology Nursing: the Official Journal of the Society of Gastroenterology Nurses and Associates
https://www.readbyqxmd.com/read/27853743/a-novel-adjunctive-cleansing-method-to-reduce-colony-forming-units-on-duodenoscopes
#9
Karl Kwok, Joseph Chang, Simon Lo, Andrew Giap, Brian Lim, Bechien Wu
Background and study aims: Endoscopic retrograde cholangiopancreatography-related infections are of increasing global concern due to the emergence of multidrug-resistant bacteria such as carbapenem-resistant enterobacteriaceae (CRE), with bacterial biofilm production postulated as one cause of persistent infection from such virulent organisms. Because N-acetylcysteine (NAC) has been shown to possess antibacterial and biofilm-disruption properties, we aimed to evaluate if NAC would demonstrate clinical utility in reducing the colony forming units (CFU) at the elevator end of a duodenoscope, one of the hardest areas to clean...
November 2016: Endoscopy International Open
https://www.readbyqxmd.com/read/27818222/adenosine-triphosphate-bioluminescence-for-bacteriologic-surveillance-and-reprocessing-strategies-for-minimizing-risk-of-infection-transmission-by-duodenoscopes
#10
Saurabh Sethi, Robert J Huang, Monique T Barakat, Niaz Banaei, Shai Friedland, Subhas Banerjee
BACKGROUND AND AIMS: Recent outbreaks of duodenoscope-transmitted infections underscore the importance of adequate endoscope reprocessing. Adenosine triphosphate (ATP) bioluminescence testing allows rapid evaluation of endoscopes for bacteriologic/biologic residue. In this prospective study we evaluate the utility of ATP in bacteriologic surveillance and the effects of endoscopy staff education and dual cycles of cleaning and high-level disinfection (HLD) on endoscope reprocessing. METHODS: ATP bioluminescence was measured after precleaning, manual cleaning, and HLD on rinsates from suction-biopsy channels of all endoscopes and elevator channels of duodenoscopes/linear echoendoscopes after use...
November 3, 2016: Gastrointestinal Endoscopy
https://www.readbyqxmd.com/read/27805536/-outbreaks-related-to-contaminated-duodenoscopes-causes-and-solutions
#11
A W Rauwers, M C Vos, J W Poley, J G Buijs-Hegeman, M J Bruno
Duodenoscopes for Endoscopic Retrograde Cholangiopancreatography (ERCP) are used for diagnostic and, presently predominantly, for minimally invasive therapeutic procedures involving the biliary tree and the pancreatic duct. In 2012, in the Erasmus MC in the Netherlands, a large outbreak of multidrug-resistant bacteria was caused by a contaminated duodenoscope; its design was such that thorough cleaning was not possible. Worldwide, an increasing number of outbreaks involving multidrug-resistant bacteria caused by contaminated duodenoscopes have been reported on...
2016: Nederlands Tijdschrift Voor Geneeskunde
https://www.readbyqxmd.com/read/27761747/endoclip-therapy-of-post-sphincterotomy-bleeding-using-a-transparent-cap-fitted-forward-viewing-gastroscope
#12
Hyung Ku Chon, Tae Hyeon Kim
BACKGROUND: The incidence of post-endoscopic sphincterotomy (ES) bleeding is reportedly 2.0-5.0 %. Among various hemostatic methods, endoclip therapy is an effective modality in gastrointestinal bleeding. However, endoclip application for post-ES hemorrhage has not been widely studied, partly because of the difficulty in placing of clips using a duodenoscope. A cap-fitted forward-viewing gastroscope can easily visualize the major papilla and overcome the technical difficulty in applying endoclips...
October 19, 2016: Surgical Endoscopy
https://www.readbyqxmd.com/read/27665262/endoscopic-ultrasonography-guided-drainage-combined-with-trans-duodenoscope-cyclic-irrigation-technique-for-walled-off-pancreatic-necrosis
#13
Ying-Chun Ren, Su-Min Chen, Xiao-Bo Cai, Bai-Wen Li, Xin-Jian Wan
BACKGROUND: Endoscopic ultrasonography-guided drainage has been established as a good treatment modality in the management of walled-off pancreatic necrosis, but the unmanageable infection of postoperation is still a thorny problem due to the poor drainage ability for solid necrotic debris only through transmural stent and nasocystic catheter. AIMS: Introduce a novel therapeutic method, namely endoscopic ultrasonography-guided drainage combined with cyclic irrigation technique in managing patients with walled-off pancreatic necrosis...
January 2017: Digestive and Liver Disease
https://www.readbyqxmd.com/read/27595583/current-practice-of-duodenoscope-reprocessing
#14
REVIEW
Stephen Kim, V Raman Muthusamy
Numerous outbreaks of duodenoscope-associated transmission of multi-drug resistant bacteria have recently been reported. Unlike prior episodes of endoscope-transmitted infections, the latest outbreaks have occurred despite strict adherence to duodenoscope reprocessing guidelines. The current standard for all flexible endoscope reprocessing includes pre-cleaning, leak testing, an additional manual cleaning step, and high-level disinfection. When these steps are strictly followed, the risk of infection transmission during endoscopy is exceedingly rare...
October 2016: Current Gastroenterology Reports
https://www.readbyqxmd.com/read/27531563/technical-tips-for-peroral-transluminal-cholangioscopy-using-novel-single-operator-cholangioscope-with-videos
#15
Takeshi Ogura, Wataru Takagi, Yoshitaka Kurisu, Kazuhide Higuchi
Endoscopic retrograde cholangiopancreatography (ERCP) is the gold-standard modality for diagnosis and therapy of bilio-pancreatic disease. In particular, peroral cholangiography (POCS) is a useful modality not only for diagnosing biliary disease, but also for therapeutic procedures such as electrohydraulic lithotripsy. The SPY-DS single-operator cholangioscope has recently become available, and offers favorable visualization, a wide view, suction function and a larger accessory working channel. However, if the duodenoscope cannot be advanced into the ampulla of Vater for reasons such as surgical anatomy, POCS cannot be performed...
October 2016: Journal of Hepato-biliary-pancreatic Sciences
https://www.readbyqxmd.com/read/27478029/risk-of-infection-transmission-in-curvilinear-array-echoendoscopes-results-of-a-prospective-reprocessing-and%C3%A2-culture-registry
#16
Christopher G Chapman, Uzma D Siddiqui, Maricarmen Manzano, Vani J Konda, Cynthia Murillo, Emily M Landon, Irving Waxman
BACKGROUND AND AIMS: The complex design of the elevator mechanism in duodenoscopes has been recognized as a challenge for disinfection and recently implicated as a potential source of persistent bacterial contamination. Curvilinear array (CLA) echoendoscopes also have an elevator mechanism; however, there are no recommendations or data regarding the risk of persistent bacterial contamination of echoendoscopes. Here we hoped to determine the yield of microbial growth with routine bacterial surveillance cultures of reprocessed CLA echoendoscopes...
February 2017: Gastrointestinal Endoscopy
https://www.readbyqxmd.com/read/27469303/olympus-chose-not-to-alert-us-doctors-of-infections-linked-to-its-duodenoscopes
#17
Michael McCarthy
No abstract text is available yet for this article.
July 27, 2016: BMJ: British Medical Journal
https://www.readbyqxmd.com/read/27437409/epidemiologic-review-of-carbapenem-resistant-enterobacteriaceae-and-duodenoscopes-in-the-department-of-veterans-affairs
#18
Russell Ryono, Patricia Schirmer, Cynthia Lucero-Obusan, Gina Oda, Jason Dominitz, Mark Holodniy
No abstract text is available yet for this article.
December 2015: Open Forum Infectious Diseases
https://www.readbyqxmd.com/read/27425799/enhanced-methods-for-duodenoscope-reprocessing-answers-or%C3%A2-just-more-questions
#19
EDITORIAL
Andrew S Ross
No abstract text is available yet for this article.
August 2016: Gastrointestinal Endoscopy
https://www.readbyqxmd.com/read/27310408/outbreaks-associated-with-duodenoscopes-new-challenges-and-controversies
#20
Zachary A Rubin, Rekha K Murthy
PURPOSE OF REVIEW: Recent outbreaks of carbapenem-resistant enterobacteriaceae related to duodenoscopes in the United States and Europe have gained international attention and resulted in new regulations, especially in the United States, affecting healthcare facilities. In this review, we summarize findings from recent duodenoscope-related outbreaks, highlight what is known about the risk of transmission from these devices and discuss controversies about current recommendations to prevent transmission...
August 2016: Current Opinion in Infectious Diseases
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