{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,3,31]],"date-time":"2026-03-31T07:03:55Z","timestamp":1774940635909,"version":"3.50.1"},"reference-count":17,"publisher":"Frontiers Media SA","license":[{"start":{"date-parts":[[2026,3,31]],"date-time":"2026-03-31T00:00:00Z","timestamp":1774915200000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"content-domain":{"domain":["frontiersin.org"],"crossmark-restriction":true},"short-container-title":["Front. Pediatr."],"abstract":"<jats:sec>\n                    <jats:title>Background<\/jats:title>\n                    <jats:p>Endoscopic retrograde cholangiopancreatography (ERCP) is a key diagnostic and therapeutic tool for hepato-pancreato-biliary conditions. Although widely performed in adults, ERCP in pediatric populations is less common and poses unique challenges, particularly concerning infection control. Reusable duodenoscopes have been linked to patient-to-patient transmission of multidrug-resistant organisms (MDROs), leading to increased interest in single-use duodenoscopes. This study describes the initial experience using single-use duodenoscopes in ERCP at a single pediatric quaternary care center.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Methods<\/jats:title>\n                    <jats:p>A retrospective chart review was conducted on all patients who underwent ERCP with the EXALT\u2122 Model D single-use duodenoscope at a single pediatric center from November 1, 2022, to April 15, 2025. Demographics, procedural details, ERCP complexity scores, and post-procedure complications were collected. Descriptive statistics were used for analysis.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Results<\/jats:title>\n                    <jats:p>\n                      Twenty-eight patients (mean age 16 years; 64% female) underwent ERCP with a single-use duodenoscope. Biliary cannulation was successful in 100% of cases. Most procedures were ASGE grade 1 or 2. Stone extraction was performed in 27 cases, stent removal in 25, and new stent placement in 3. Complications occurred in 4 patients (14%): abdominal pain (\n                      <jats:italic>n<\/jats:italic>\n                      \u2009=\u20092), post-ERCP pancreatitis (\n                      <jats:italic>n<\/jats:italic>\n                      \u2009=\u20091), and cholangitis (\n                      <jats:italic>n<\/jats:italic>\n                      \u2009=\u20091), with no cases of post-procedure bleeding or MDRO infections. No procedures required conversion to reusable duodenoscopes.\n                    <\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Conclusions<\/jats:title>\n                    <jats:p>Single-use duodenoscopes were effective and safe for ERCP in a pediatric cohort, achieving high technical success and low complication rates. While more studies are needed, particularly in younger or smaller patients and at higher ASGE grades (3 and 4), single-use duodenoscopes may offer a promising alternative to reusable devices, especially in reducing infection risk and simplifying scope maintenance. Broader adoption may depend on the development of pediatric-specific devices and cost-benefit analyses in varying clinical settings.<\/jats:p>\n                  <\/jats:sec>","DOI":"10.3389\/fped.2026.1721719","type":"journal-article","created":{"date-parts":[[2026,3,31]],"date-time":"2026-03-31T05:32:45Z","timestamp":1774935165000},"update-policy":"https:\/\/doi.org\/10.3389\/crossmark-policy","source":"Crossref","is-referenced-by-count":0,"title":["Single pediatric center experience with single-use duodenoscopes"],"prefix":"10.3389","volume":"14","author":[{"given":"Sapna","family":"Khemka","sequence":"first","affiliation":[{"name":"Division of Gastroenterology, Hepatology & Nutrition, Nationwide Children's Hospital","place":["Columbus, Ohio, United States"]}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Micah","family":"Morris","sequence":"additional","affiliation":[{"name":"Division of Gastroenterology, Hepatology & Nutrition, Nationwide Children's Hospital","place":["Columbus, Ohio, United States"]}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Colin","family":"Winkie","sequence":"additional","affiliation":[{"name":"Division of Gastroenterology, Hepatology & Nutrition, Nationwide Children's Hospital","place":["Columbus, Ohio, United States"]}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Muhammad A.","family":"Khan","sequence":"additional","affiliation":[{"name":"Division of Gastroenterology, Hepatology & Nutrition, Nationwide Children's Hospital","place":["Columbus, Ohio, United States"]}],"role":[{"role":"author","vocabulary":"crossref"}]}],"member":"1965","published-online":{"date-parts":[[2026,3,31]]},"reference":[{"key":"B1","doi-asserted-by":"publisher","first-page":"E761","DOI":"10.1055\/a-1134-4873","article-title":"Use of ERCP in the United States over the past decade","volume":"8","author":"Kr\u00f6ner","year":"2020","journal-title":"Endosc Int Open"},{"key":"B2","doi-asserted-by":"publisher","first-page":"159","DOI":"10.1016\/j.jpeds.2020.11.019","article-title":"Nationwide evolution of pediatric endoscopic retrograde cholangiopancreatography indications, utilization, and readmissions over time","volume":"232","author":"Barakat","year":"2021","journal-title":"J Pediatr"},{"key":"B3","doi-asserted-by":"publisher","first-page":"723","DOI":"10.1016\/j.giec.2020.06.009","article-title":"Gastrointestinal flexible endoscopes: infection control risks, lessons learned from outbreaks, and centers for disease control and prevention guidance","volume":"30","author":"Benowitz","year":"2020","journal-title":"Gastrointest Endosc Clin N Am"},{"key":"B4","year":"2025"},{"key":"B5","doi-asserted-by":"publisher","first-page":"100451","DOI":"10.1016\/j.eclinm.2020.100451","article-title":"Rate and impact of duodenoscope contamination: a systematic review and 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Gastroenterol Hepatol"},{"key":"B9","doi-asserted-by":"publisher","first-page":"3543","DOI":"10.1007\/s00464-015-4105-1","article-title":"Technical outcomes and complications of pediatric ERCP","volume":"29","author":"Giefer","year":"2015","journal-title":"Surg Endosc"},{"key":"B10","doi-asserted-by":"publisher","first-page":"755","DOI":"10.1097\/MPG.0000000000003612","article-title":"Technical outcomes in pediatric endoscopic retrograde cholangiopancreatography: data from an international collaborative","volume":"75","author":"Troendle","year":"2022","journal-title":"J Pediatr Gastroenterol Nutr"},{"key":"B11","doi-asserted-by":"publisher","first-page":"71","DOI":"10.1016\/j.hbpd.2023.04.002","article-title":"The outcomes and safety of patients undergoing endoscopic retrograde cholangiopancreatography combining a single-use cholangioscope and a single-use duodenoscope: a multicenter retrospective international study","volume":"23","author":"Fugazza","year":"2024","journal-title":"Hepatobiliary Pancreat Dis Int"},{"key":"B12","doi-asserted-by":"publisher","first-page":"935","DOI":"10.1111\/jgh.16492","article-title":"Endoscopic retrograde cholangiopancreatography-obtained bile culture in acute cholangitis: retrospective analysis of bile cultures and risk factors in a tertiary care center","volume":"39","author":"Stathopoulos","year":"2024","journal-title":"J Gastroenterol Hepatol"},{"key":"B13","doi-asserted-by":"publisher","first-page":"1","DOI":"10.37421\/pe.2020.5.125","article-title":"The total cost of reusable duodenoscopes: are single-use duodenoscopes the future of ERCP?","volume":"5","author":"Travis","year":"2020","journal-title":"Pharmacoeconomics"},{"key":"B14","doi-asserted-by":"publisher","first-page":"1718","DOI":"10.1007\/s10620-022-07441-8","article-title":"Gastrointestinal endoscopy-associated infections: update on an emerging 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