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Duodenoscope

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https://www.readbyqxmd.com/read/28711629/randomized-comparison-of-3-high-level-disinfection-and-sterilization-procedures-for-duodenoscopes
#1
Graham M Snyder, Sharon B Wright, Anne Smithey, Meir Mizrahi, Michelle Sheppard, Elizabeth B Hirsch, Ram Chuttani, Riley Heroux, David S Yassa, Lovisa B Olafsdottir, Roger B Davis, Anastasiou Jiannis, Vijay Bapat, Kiran Bidari, Douglas K Pleskow, Daniel Leffler, Benjamin Lane, Alice Chen, Howard S Gold, Anthony Bartley, Aleah D King, Mandeep S Sawhney
BACKGROUND AND AIMS: Duodenoscopes have been implicated in the transmission of multi-drug resistant bacteria (MDRO). We compared the frequency of duodenoscope contamination with MDRO or any other bacteria after disinfection or sterilization by 3 different methods. METHODS: We performed a single-center prospective randomized study in which duodenoscopes were randomly reprocessed by standard high-level disinfection (sHLD), double high-level disinfection (dHLD), or standard high-level disinfection followed by ethylene oxide gas sterilization (HLD/ETO)...
July 12, 2017: Gastroenterology
https://www.readbyqxmd.com/read/28647354/the-future-of-endoscopic-retrograde%C3%A2-cholangiopancreatography
#2
EDITORIAL
Patrick S Yachimski, Andrew Ross
No abstract text is available yet for this article.
June 21, 2017: Gastroenterology
https://www.readbyqxmd.com/read/28617887/peroral-cholangiopancreatoscopy-with-the-spyglass%C3%A2-system-what-do-we-know-10-years-later
#3
REVIEW
Pedro Pereira, Armando Peixoto, Patrícia Andrade, Guilherme Macedo
Smaller endoscopes and catheters have been developed that permit direct visualization of the bile and pancreatic ducts (cholangioscopy and pancreatoscopy, respectively). These endoscopes and catheters are passed through the working channel of a standard therapeutic duodenoscope during endoscopic retrograde cholangiopancreatography (ERCP). The SpyGlass Direct Visualization System (Boston Scientific Corp, Natick, MA, USA) is currently the most widely used and studied device. Cholangioscopy with intraductal lithotripsy has become an established modality in the treatment of difficult biliary lithiasis...
June 2017: Journal of Gastrointestinal and Liver Diseases: JGLD
https://www.readbyqxmd.com/read/28499830/implementation-of-a-systematic-culturing-program-to-monitor-the-efficacy-of-endoscope-reprocessing-outcomes-and-costs
#4
Gene K Ma, David A Pegues, Michael L Kochman, Kevin Alby, Neil O Fishman, Marianne Saunders, Carolyn Grous, Daniel T Dempsey, Gregory G Ginsberg
BACKGROUND AND AIMS: In 2015, the U.S. Food and Drug Administration and Centers for Disease Control and Prevention (CDC) issued guidance for duodenoscope culturing and reprocessing in response to outbreaks of carbapenem-resistant Enterobacteriaceae (CRE) duodenoscope-related infections. Based on this guidance, we implemented best practices for reprocessing and developed a systematic process for culturing endoscopes with elevator levers. The aim of this study is to report the outcomes and direct costs of this program...
May 10, 2017: Gastrointestinal Endoscopy
https://www.readbyqxmd.com/read/28493162/single-setting-endoscopic-retrograde-cholangiopancreatography-ercp-and-cholecystectomy-improve-the-rate-of-surgical-site-infection
#5
Michele M Loor, Jean Dominique Morancy, James K Glover, Gregory J Beilman, Catherine L Statz
INTRODUCTION: Cholecystectomy is a common surgical procedure. The presence of common bile duct stones complicates treatment, often requiring a second procedure for stone retrieval. For such patients, endoscopic retrograde cholangiopancreatography (ERCP) provides adequate therapy, and can be performed before, after, or at the same time as cholecystectomy. In 2013, duodenoscopes were implicated by the Centers for Disease Control and Prevention in transmission of carbapenem-resistant Enterobacteriaceae...
May 10, 2017: Surgical Endoscopy
https://www.readbyqxmd.com/read/28492880/maker-of-duodenoscopes-under-scrutiny-again
#6
Jeff Lyon
No abstract text is available yet for this article.
May 9, 2017: JAMA: the Journal of the American Medical Association
https://www.readbyqxmd.com/read/28439498/gastric-and-duodenal-polyps-in-familial-adenomatous-polyposis-patients-conventional-endoscopy-vs-virtual-chromoendoscopy-fujinon-intelligent-color-enhancement-in-dysplasia-evaluation
#7
Gabriele Lami, Andrea Galli, Giuseppe Macrì, Emanuele Dabizzi, Maria Rosa Biagini, Mirko Tarocchi, Luca Messerini, Rosa Valanzano, Stefano Milani, Simone Polvani
AIM: To test the fujinon intelligent color enhancement (FICE) in identifying dysplastic or adenomatous polyps in familial adenomatous polyposis (FAP) patients. METHODS: Seventy-six consecutive FAP patients, already treated by colectomy and members of sixty-five families, were enrolled. A FICE system for the upper gastro-intestinal tract with an electronic endoscope system and a standard duodenoscope (for side-viewing examination) were used by two expert examiners...
April 10, 2017: World Journal of Clinical Oncology
https://www.readbyqxmd.com/read/28414009/adenosine-triphosphate-quantification-correlates-poorly-with-microbial-contamination-of-duodenoscopes
#8
Lovisa B Olafsdottir, Sharon B Wright, Anne Smithey, Riley Heroux, Elizabeth B Hirsch, Alice Chen, Benjamin Lane, Mandeep S Sawhney, Graham M Snyder
OBJECTIVE The aim of this study was to quantify the correlation between adenosine triphosphate (ATP) measurements and bacterial cultures from duodenoscopes for evaluation of contamination following high-level disinfection. DESIGN Duodenoscopes used for any intended endoscopic retrograde cholangiopancreatography (ERCP) procedure were included. Microbiologic and ATP data were collected concomitantly and in the same manner from ERCP duodenoscopes. SETTING A high-volume endoscopy unit at a tertiary referral acute-care facility...
April 17, 2017: Infection Control and Hospital Epidemiology
https://www.readbyqxmd.com/read/28396277/duodenoscope-reprocessing-surveillance-with-adenosine-triphosphate-testing-and-terminal-cultures-a-clinical-pilot-study
#9
Kavel Visrodia, Yuri Hanada, Kelly M Pennington, Pritish K Tosh, Mark D Topazian, Bret T Petersen
BACKGROUND AND AIMS: Recent reports of infectious outbreaks linked to duodenoscopes have led to proposals for duodenoscope surveillance culturing, which has inherent limitations. We aimed to assess the feasibility of real-time adenosine triphosphate (ATP) testing after manual cleaning and its ability to predict reprocessing adequacy, as determined by terminal duodenoscope cultures. METHODS: Clinically used duodenoscopes underwent reprocessing per current guidelines...
July 2017: Gastrointestinal Endoscopy
https://www.readbyqxmd.com/read/28395382/endoscopic-ultrasound-guided-creation-of-a-transgastric-fistula-for-the-management-of-hepatobiliary-disease-in-patients-with-roux-en-y-gastric-bypass
#10
Saowanee Ngamruengphong, Jose Nieto, Rastislav Kunda, Vivek Kumbhari, Yen-I Chen, Majidah Bukhari, Mohamad Hassan El Zein, Renata P Bueno, Gulara Hajiyeva, Amr Ismail, Yamile Haito Chavez, Mouen A Khashab
Background and aims Endoscopic retrograde cholangiopancreatography (ERCP) in patients who have undergone Roux-en-Y gastric bypass (RYGB) is technically challenging. We describe our multicenter experience using lumen-apposing metal stents (LAMSs) to create an endoscopic ultrasound-guided transgastric fistula (EUS-TG) to facilitate peroral ERCP in these patients. Patients and methods Thirteen patients with RYGB who underwent EUS-TG at three tertiary centers were included. EUS was used to guide puncture of the excluded stomach from the gastric pouch or jejunum; a LAMS was placed across the transgastric fistula...
April 10, 2017: Endoscopy
https://www.readbyqxmd.com/read/28360977/endoscopic-retrograde-cholangiopancretography-in-modified-double-tracks-anastomosis-with-anastomotic-stenosis
#11
Xiao-Song Wang, Fei Wang, Quan-Peng Li, Lin Miao, Xiu-Hua Zhang
A 63-year-old man presented at our hospital with right upper abdomen pain and fever for 4 d. The patient's magnetic resonance cholangiopancreatography revealed dilated common bile duct and choledocholithiasis. In his past history, he received proximal gastrectomy and modified double tracks anastomosis. Endoscopic retrograde cholangiopancretography in modified double tracks anastomosis, especially accompanied with anastomotic stenosis, has been rarely reported. In the present case, the duodenoscope was successfully introduced over the guidewire and the stone taken out using a basket...
March 16, 2017: World Journal of Gastrointestinal Endoscopy
https://www.readbyqxmd.com/read/28341284/prospective-microbiologic-evaluation-of-the-forceps-elevator-in-closed-channel-duodenoscopes-after-reprocessing
#12
Helga Paula, Barbara Tribl, Elisabeth Presterl, Magda Diab-El Schahawi
BACKGROUND: Endoscopes are well-known sources of bacterial transmission in health care facilities offering endoscopy services. The association between multidrug-resistant bacterial infections in patients who had undergone an endoscopic retrograde cholangiopancreatography procedure with reprocessed duodenoscopes has been much discussed. Bacterial contamination of duodenoscopes has been attributed to difficulties with reprocessing these devices, specifically the distal end of the scope, which features a movable forceps elevator...
February 1, 2017: American Journal of Infection Control
https://www.readbyqxmd.com/read/28241955/clinical-issues-march-2017
#13
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
#14
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...
July 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
#15
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)...
June 2017: Digestive and Liver Disease
https://www.readbyqxmd.com/read/28176466/safety-and-efficacy-of-a-novel-continuous-incision-technique-for-laparoscopic-transcystic-choledocholithotomy
#16
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
#17
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
#18
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...
April 1, 2017: 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
#19
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
#20
REVIEW
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
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