{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,6,8]],"date-time":"2026-06-08T10:51:57Z","timestamp":1780915917932,"version":"3.54.1"},"reference-count":20,"publisher":"MDPI AG","issue":"5","license":[{"start":{"date-parts":[[2023,4,26]],"date-time":"2023-04-26T00:00:00Z","timestamp":1682467200000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":["Bioengineering"],"abstract":"<jats:p>Background: Endoscopic retrograde cholangiopancreatography (ERCP) is crucial to the treatment of biliopancreatic diseases with iatrogenic perforation as a potential complication. As of yet, the wall load during ERCP is unknown, as it is not directly measurable during an ERCP in patients. Methods: In a life-like, animal-free model, a sensor system consisting of five load cells was attached to the artificial intestines (sensors 1 + 2: pyloric canal\u2013pyloric antrum, sensor 3: duodenal bulb, sensor 4: descending part of the duodenum, sensor 5: distal to the papilla). Measurements were made with five duodenoscopes (n = 4 reusable and n = 1 single use). Results: Fifteen standardized duodenoscopies were performed. Peak stresses were found at the antrum during the gastrointestinal transit (sensor 1 max. 8.95 N, sensor 2 max. 2.79 N). The load reduced from the proximal to the distal duodenum and the greatest load in the duodenum was discovered at the level of the papilla in 80.0% (sensor 3 max. 2.06 N). Conclusions: For the first time, intraprocedural load measurements and exerting forces obtained during a duodenoscopy for ERCP in an artificial model were recorded. None of the tested duodenoscopes were classified as dangerous for patient safety.<\/jats:p>","DOI":"10.3390\/bioengineering10050523","type":"journal-article","created":{"date-parts":[[2023,4,26]],"date-time":"2023-04-26T02:30:52Z","timestamp":1682476252000},"page":"523","update-policy":"https:\/\/doi.org\/10.3390\/mdpi_crossmark_policy","source":"Crossref","is-referenced-by-count":5,"title":["Exerting Forces and Wall Load during Duodenoscopy for ERCP: An Experimental Measurement in an Artificial Model"],"prefix":"10.3390","volume":"10","author":[{"given":"Julian","family":"Schneider","sequence":"first","affiliation":[{"name":"Department for General, Visceral and Transplantation Surgery at the University Hospital of T\u00fcbingen, Workgroup for Experimental Endoscopy, Development and Training, Waldh\u00f6rnlestrasse 22, 72072 T\u00fcbingen, Germany"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-2352-2325","authenticated-orcid":false,"given":"Benedikt","family":"Duckworth-Mothes","sequence":"additional","affiliation":[{"name":"Department for General, Visceral and Transplantation Surgery at the University Hospital of T\u00fcbingen, Workgroup for Experimental Endoscopy, Development and Training, Waldh\u00f6rnlestrasse 22, 72072 T\u00fcbingen, Germany"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Ulrich","family":"Schweizer","sequence":"additional","affiliation":[{"name":"Department for General, Visceral and Transplantation Surgery at the University Hospital of T\u00fcbingen, Workgroup for Experimental Endoscopy, Development and Training, Waldh\u00f6rnlestrasse 22, 72072 T\u00fcbingen, Germany"},{"name":"Interdisciplinary Endoscopic Unit, University Hospital of T\u00fcbingen, Otfried-M\u00fcller-Str. 10, 72076 T\u00fcbingen, Germany"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Alfred","family":"K\u00f6nigsrainer","sequence":"additional","affiliation":[{"name":"Department for General, Visceral and Transplantation Surgery at the University Hospital of T\u00fcbingen, Workgroup for Experimental Endoscopy, Development and Training, Waldh\u00f6rnlestrasse 22, 72072 T\u00fcbingen, Germany"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Jakob","family":"Fisch","sequence":"additional","affiliation":[{"name":"Interdisciplinary Endoscopic Unit, University Hospital of T\u00fcbingen, Otfried-M\u00fcller-Str. 10, 72076 T\u00fcbingen, Germany"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-8832-5031","authenticated-orcid":false,"given":"D\u00f6rte","family":"Wichmann","sequence":"additional","affiliation":[{"name":"Department for General, Visceral and Transplantation Surgery at the University Hospital of T\u00fcbingen, Workgroup for Experimental Endoscopy, Development and Training, Waldh\u00f6rnlestrasse 22, 72072 T\u00fcbingen, Germany"},{"name":"Interdisciplinary Endoscopic Unit, University Hospital of T\u00fcbingen, Otfried-M\u00fcller-Str. 10, 72076 T\u00fcbingen, Germany"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"1968","published-online":{"date-parts":[[2023,4,26]]},"reference":[{"key":"ref_1","doi-asserted-by":"crossref","first-page":"191","DOI":"10.1097\/00000658-200008000-00007","article-title":"Management of Duodenal Perforation After Endoscopic Retrograde Cholangiopancreatography and Sphincterotomy","volume":"232","author":"Stapfer","year":"2000","journal-title":"Ann. 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