Reuse of disposable sphincterotomes for diagnostic and therapeutic ERCP: a one-year prospective study.
BACKGROUND
Although previous studies have documented that single-channel sphincterotomes can be sterilized and used up to 10 times, no studies have prospectively evaluated the reuse of disposable sphincterotomes.


METHODS
Five- and six-French double-channel sphincterotomes marketed as one-time-use only were manually cleaned, sterilized with ethylene oxide, and used up to 10 times. Over a 1-year period, total number of uses as a cannulation or cutting device, reason for sphincterotome dysfunction, possible infectious complications were evaluated, and cost-savings associated with reuse were evaluated.


RESULTS
The mean number of times sphincterotomes could be used in our institution was 3.4; a broken or stiff cutting wire was the main reason for discard. There were two infectious complications during the study period. Both were experienced by patients with unrelieved obstruction treated with new sphincterotomes. Contingent on the method used, total savings related to sphincterotome reuse was approximately $66,000.


CONCLUSIONS
Double-channel sphincterotomes marketed as one-time-use items can be reused safely when properly cleaned. Reuse was associated with significant cost savings in our institution.
Kozarek
R A
RA
Section of Gastroenterology, Virginia Mason Medical Center, Seattle, Washington 98111, USA.
Raltz
S L
SL
Ball
T J
TJ
Patterson
D J
DJ
Brandabur
J J
JJ
D002760:Cholangiopancreatography, Endoscopic Retrograde / Q000191:economics / Q000295:instrumentation*; D002761:Cholangitis / Q000209:etiology; D002779:Cholestasis / Q000175:diagnosis / Q000601:surgery; D003365:Costs and Cost Analysis; D004209:Disposable Equipment / Q000191:economics; D004866:Equipment Contamination; D005500:Follow-Up Studies; D006801:Humans; D011446:Prospective Studies; D016717:Sphincterotomy, Endoscopic / Q000191:economics / Q000295:instrumentation*; D013530:Surgical Wound Infection / Q000209:etiology