Olafsdottir LB, et al. - Researchers performed a systematic review to determine if adenosine triphosphate is a surrogate for bacterial contamination of duodenoscopes used for endoscopic retrograde cholangiopancreatography. Findings provided no support to the direct substitution of ATP for bacterial culture surveillance of duodenoscopes. To evaluate the adequacy of manual cleaning and for training of endoscopic reprocessing staff, serial ATP measurement could be a useful tool.