Single pediatric center experience with single-use duodenoscopes

Background: 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. Methods: A retrospective chart review was conducted on all patients who underwent ERCP with the EXALT™ 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. Results: = 1), with no cases of post-procedure bleeding or MDRO infections. No procedures required conversion to reusable duodenoscopes. Conclusions: 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.