Disposable elevator-cap (DEC) duodenoscopes were designed to reduce residual contamination after reprocessing and thereby lower the risk of infection transmission. We compared clinical outcomes of DEC versus conventional duodenoscopes, focusing on post-ERCP cholangitis and multidrug-resistant (MDR) cholangitis in routine practice.

In a prospective, single-center cohort, consecutive ERCP patients were followed for post-procedural outcomes. Routine post–high-level disinfection (HLD) surveillance cultures were also performed during the study period.

Interim analysis was conducted after enrollment of 1,039 patients (318 in the DEC group and 721 in the conventional group). Technical success was similar (DEC 98.7% vs conventional 98.2%), while mean procedure time was shorter with DEC (15.7 ± 9.0 vs 17.5 ± 9.8 minutes; p=0.003). The incidence of overall post-ERCP cholangitis was comparable between groups (10.1% in DEC vs 8.0% in conventional, p=0.20). After adjustment, no significant difference was observed (OR, 1.28; 95% CI, 0.80–2.06; p=0.31). DEC tended to be more protective for MDR cholangitis without statistical significance (OR, 0.74; 95% CI, 0.27–1.99; p=0.55). In parallel, post-HLD surveillance cultures revealed microbial contamination only in conventional duodenoscopes, whereas no growth was detected in DEC-equipped duodenoscopes.

This interim analysis showed no significant difference in post-ERCP or MDR cholangitis between DEC and conventional duodenoscopes, leading to early study termination. The absence of microbial growth during surveillance in the DEC group supports a potential infection-prevention advantage of the device.