Background Catheter/guidewire exchanges during ERCP require the coordinated ef forts of an endoscopist and endoscopy assistant. Aprototype duodenoscopewas deve loped to improve the control of catheter/guidewire exchan...Background Catheter/guidewire exchanges during ERCP require the coordinated ef forts of an endoscopist and endoscopy assistant. Aprototype duodenoscopewas deve loped to improve the control of catheter/guidewire exchange by enabling fixation of guidewires at the elevator lever. MethodsAn initial prototype duodenoscope a nd a subsequent modification of this instrument were used to perform ERCP in 7 a nd 10 patients, respectively.The following were recorded: total procedure time, fluoroscopy time, catheter/guidewire exchange time, guidewire repositioning,loss of guidewire access, success or failure of fixation,and endoscopist satisfactio n. Observations The initial and the modified prototype duodenoscopes were used i n a variety of catheter/guidewire exchanges (n=46). Guidewire fixation was achie ved in 75%of catheter/guidewire exchanges with the initial prototype and in 93 %with the modified prototype and was reflected in shorter exchange times. Acces s to the desired duct was not lost during any exchange, and the need for reposit ioning was eliminated. Conclusions A new prototype duodenoscope with an elevator lever that enables guidewire fixation will improve the ease and efficiency of c atheter/guidewire exchange during ERCP. Modifications made to the original proto type improved reliability of guidewire fixation.展开更多
文摘Background Catheter/guidewire exchanges during ERCP require the coordinated ef forts of an endoscopist and endoscopy assistant. Aprototype duodenoscopewas deve loped to improve the control of catheter/guidewire exchange by enabling fixation of guidewires at the elevator lever. MethodsAn initial prototype duodenoscope a nd a subsequent modification of this instrument were used to perform ERCP in 7 a nd 10 patients, respectively.The following were recorded: total procedure time, fluoroscopy time, catheter/guidewire exchange time, guidewire repositioning,loss of guidewire access, success or failure of fixation,and endoscopist satisfactio n. Observations The initial and the modified prototype duodenoscopes were used i n a variety of catheter/guidewire exchanges (n=46). Guidewire fixation was achie ved in 75%of catheter/guidewire exchanges with the initial prototype and in 93 %with the modified prototype and was reflected in shorter exchange times. Acces s to the desired duct was not lost during any exchange, and the need for reposit ioning was eliminated. Conclusions A new prototype duodenoscope with an elevator lever that enables guidewire fixation will improve the ease and efficiency of c atheter/guidewire exchange during ERCP. Modifications made to the original proto type improved reliability of guidewire fixation.
