A PROSPECTIVE-STUDY OF THE REPEATED USE OF STERILIZED PAPILLOTOMES AND RETRIEVAL BASKETS FOR ERCP - QUALITY AND COST-ANALYSIS

Background: The impact on instrument quality and cost of the practice of reusing ERCP accessories has not been fully addressed. Methods: Twe nty-five new papillotomes and 15 new retrieval baskets were labeled an d evaluated over time by staff blinded to the number of prior uses. In struments were scored as to their function for the designated task. Th e cost of this practice was calculated from the purchase price of acce ssories and the costs of cleaning, sterilization, and disposal, and th en compared with the estimated cost of a practice of one-time use of s imilar instruments. Results: Twenty-five papillotomes were used 246 ti mes (median 8; mean 9.8). Fifteen retrieval baskets were used 193 time s (median 13; mean 12.9). The median survival of both papillotomes and baskets before being considered inadequate (score <6 out of 10) was 9 uses. There were no complications attributable to using reused equipm ent. The projected yearly cost savings of using reusable versus dispos able instruments was $94,095 for papillotomes and $61,809 for baskets, a 475% and 322% cost reduction, respectively. Conclusion: The papillo tomes and baskets in this study could be reused reliably and safely mu ltiple times, with considerable cost savings compared with the practic e of using disposable instruments.