Kozarek R A, Raltz S L, Ball T J, Patterson D J, Brandabur J J
Section of Gastroenterology, Virginia Mason Medical Center, Seattle, Washington 98111, USA.
Gastrointest Endosc. 1999 Jan;49(1):39-42. doi: 10.1016/s0016-5107(99)70443-8.
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.
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.
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.
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.
尽管先前的研究已证明单通道括约肌切开刀可以消毒并使用多达10次，但尚无研究对一次性使用的括约肌切开刀的重复使用进行前瞻性评估。
将仅作为一次性使用销售的5法式和6法式双通道括约肌切开刀进行人工清洁，用环氧乙烷消毒，并使用多达10次。在1年的时间里，评估了作为插管或切割装置的使用总次数、括约肌切开刀功能障碍的原因、可能的感染并发症，并评估了与重复使用相关的成本节约情况。
在我们机构中，括约肌切开刀的平均使用次数为3.4次；切割钢丝断裂或僵硬是丢弃的主要原因。研究期间有2例感染并发症。这两例均发生在使用新的括约肌切开刀治疗梗阻未缓解的患者身上。根据所采用的方法，括约肌切开刀重复使用带来的总节约约为66,000美元。
仅作为一次性使用销售的双通道括约肌切开刀在正确清洁后可以安全地重复使用。在我们机构中，重复使用可显著节省成本。
