Accessories are commonly used for gaining and maintaining access during ERCP. In addition, special accessories are needed for therapeutic cases The economical impact of all these accessories, is unknown. Aim: To determine the rate of utilization of ERCP accessories, their estimated costs and the potential savings gained by re-using them. Material and Methods: Inventory of the equipment used with each ERCP was reviewed in consecutive procedures. All ERCPs were performed by a third year fellow and attending endoscopist. Equipment costs were estimated using accessory catalogs, and the costs were averaged for the following groups: cannulas, wires, sphincterotomes, stone extraction devices and stents. A model for re-using ERCP equipment was developed: one cannula, one wire and one sphincterotome for every five procedures, and one stone extraction device for every three ERCPs. The estimated costs and saving for this model, were calculated and compared to the actual cost. Results: A total of 55 consecutive ERCPs were evaluated: 28 therapeutic and 27 diagnostic procedures. There were a total of 218 accessories used for all 55 ERCPs. The mean number of accessories used per ERCP was 3.9 (218/55) (range 1-10). Comparison between the overall costs using disposable and non-disposable accessories is depicted below. n Avg. Tot. Costs ($) Estimated Tot Costs Cost($) (one use) ($) (re-use) Cannulas 70 40.00 2800.00 14×40 = 560.00 Wires 63 100.00 6300.00 12×100=1200.00 Sphincterotomes 43 150.00 6450.00 8×150=1200.00 Stone retrievals 18 115.00 2070.00 6×115 = 690.00 Stent sets 11 90.00 990.00 11×90 = 990.00 Total 159 18,610.00 4,640.00 According to the model, re-using ERCP accessories afforded an estimated saving of $13,970.00 (75% reduction), for the procedures performed. Conclusion: The re-use of ERCP accessories, may be associated with significant savings. If sterilization of ERCP accessories can be achieved, this practice would likely make ERCP a more cost-effective procedure.
ASJC Scopus subject areas
- Radiology Nuclear Medicine and imaging