LAUSR

Key Points Question In patients undergoing endoscopic retrograde cholangiopancreatography (ERCP), do duodenoscopes with disposable elevator caps (1) reduce contamination rates after high-level disinfection and/or (2) maintain technical performance of the procedure compared with duodenoscopes with standard designs? Findings In this randomized clinical trial that included 518 patients undergoing ERCP of various procedural complexity, duodenoscopes with disposable caps reduced persistent microbial contamination (relative risk, 0.34), with no differences in performance (technical success, 94.6% vs 90.7%) and safety outcomes. Meaning Disposable elevator cap duodenoscopes exhibited reduced contamination following high-level disinfection compared with standard scope designs, without affecting technical performance and safety of ERCP.