Cholecystectomy during the COVID-19 pandemic: Current evidence and an understanding of the ‘new’ critical view of safety: Correspondence

Kabir, Tousif; Kam, Juinn Huar; Chew, Min Hoe

doi:10.1016/j.ijsu.2020.06.012

Cited by 6 publications

(5 citation statements)

References 11 publications

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“…Personal protective equipment (PPE) should be worn when treating COVID-19 positive or COVID-19 suspect patients undergoing emergency laparoscopic cholecystectomy. Since the aerosolization of COVID-19 virus particles during laparoscopy is not clearly evidence-based, it is recommended that laparoscopic cholecystectomy be preferred over the open procedure in COVID-19 positive patients [ 17 ].…”

Section: Discussionmentioning

confidence: 99%

Laparoscopic cholecystectomy during the COVID-19 pandemic in a tertiary care hospital in Germany: higher rates of acute and gangrenous cholecystitis in elderly patients

et al. 2022

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Background The COVID-19 pandemic caused a global health crisis in 2020. This pandemic also had a negative impact on standard procedures in general surgery. Surgeons were challenged to find the best treatment plans for patients with acute cholecystitis. The aim of this study is to investigate the impact of the COVID-19 pandemic on the outcomes of laparoscopic cholecystectomies performed in a tertiary care hospital in Germany. Patients and methods We examined perioperative outcomes of patients who underwent laparoscopic cholecystectomy during the pandemic from March 22, 2020 (first national lockdown in Germany) to December 31, 2020. We then compared these to perioperative outcomes from the same time frame of the previous year. Results A total of 182 patients who underwent laparoscopic cholecystectomy during the above-mentioned periods were enrolled. The pandemic group consisted of 100 and the control group of 82 patients. Subgroup analysis of elderly patients (> 65 years old) revealed significantly higher rates of acute [5 (17.9%) vs. 20 (58.8%); p = 0.001] and gangrenous cholecystitis [0 (0.0%) vs. 7 (20.6%); p = 0.013] in the “pandemic subgroup”. Furthermore, significantly more early cholecystectomies were performed in this subgroup [5 (17.9%) vs. 20 (58.8%); p = 0.001]. There were no significant differences between the groups both in the overall and subgroup analysis regarding the operation time, intraoperative blood loss, length of hospitalization, morbidity and mortality. Conclusion Elderly patients showed particularly higher rates of acute and gangrenous cholecystitis during the pandemic. Laparoscopic cholecystectomy can be performed safely in the COVID-19 era without negative impact on perioperative results. Therefore, we would assume that laparoscopic cholecystectomy can be recommended for any patient with acute cholecystitis, including the elderly.

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Section: Discussionmentioning

confidence: 99%

Laparoscopic cholecystectomy during the COVID-19 pandemic in a tertiary care hospital in Germany: higher rates of acute and gangrenous cholecystitis in elderly patients

et al. 2022

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“…Many studies have recommended RT‐PCR before a surgical procedure 12‐19 . Puylaert et al suggested that RT‐PCR alone had a higher yield of positive results than chest CT alone (0.7% vs 1.1%) 10 .…”

Section: Discussionmentioning

confidence: 99%

Delivery of digestive surgery services during the COVID‐19 pandemic: Indonesian Society of Digestive Surgeons online survey

Nugroho

Arifin

Wibowo

et al. 2021

Asian J Endoscop Surgery

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Introduction During the coronavirus disease 2019 (COVID‐19) pandemic, digestive surgery potentially exposes both health‐care professionals and vulnerable patients to COVID‐19. A survey was conducted with aim to determine the digestive surgery services provided during the COVID‐19 pandemic, optimize safety for patients and clinicians, and safeguard health‐care services. Methods An online survey was conceived and circulated to members of the Indonesian Society of Digestive Surgeons. The survey was conducted in two phases, in April 2020 and July 2020, to evaluate changes in response to the COVID‐19 pandemic. Results Early in the pandemic (April 2020), the median number of major digestive surgeries performed monthly declined from 20 cases (range. 3‐100 cases) to 1 case (range. 0‐10 cases) (P < .001; Wilcoxon signed‐rank test). Most of the cases in April 2020 addressed emergency problems, but more definitive surgeries were performed during the later period of the survey. The importance of screening for COVID‐19 with polymerase chain reaction has increased over time, and a more comprehensive screening methodology incorporating real‐time polymerase chain reaction, chest CT, and rapid antibody test were evident in 31.37% of July 2020 responses. Conclusion Our survey has shown that surgeons adapted to the evolving pandemic and continue to do so only with appropriate safety assurances.

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“…The objective was to avoid overloading and saturating the health care system and to reduce the exposure of staff and patients to the risk of contagion. This decision brought an increase in the progression of 50 oncological diseases as well as in the complications of benign pathologies, such as cholelithiasis, which is highly prevalent in our society, as well as becoming a limiting factor to the training of human resources [1][2][3][4][5].…”

Section: Introductionmentioning

confidence: 99%

“…The "gold standard" treatment for acute cholecystitis and acute biliary pancreatitis is laparoscopic cholecystectomy [9], which should be performed within the first 48 hours to 72 hours for the former and 4 days to 7 days for the latter. Postponing the procedure contributes to the development of progressive complications that are a frequent cause of rehospitalization and increased morbidity [1,[2][3][4][5][6][7][8].…”

Section: Introductionmentioning

confidence: 99%

Impact of COVID-19 Restrictions on Outcomes of Patients with Cholelithiasis during the Pandemic

Pereyra¹,

Ortiz²,

Mozetic³

et al. 2022

IJCICR

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Introduction: The COVID-19 pandemic restrictions forced the postponement of most elective surgeries for pathologies that did not represent an imminent risk to life. This delay caused significantly higher Re-admission and complication rates in patients with cholelithiasis during the pandemic, compared to those who presented before the pandemic (p-value=0.0001). Objective: To evaluate the impact of delayed surgical management of symptomatic gallstones, during the Covid-19 pandemic, on the complication and re-admission rates. Design Type: a descriptive retrospective. Methods: A cohort of patients hospitalized with pancreatobiliary pathology during the pandemic was compared to a control group who presented before the pandemic. Two groups were compared for the incidence of gallstone complications and re-admission rates. Primary or secondary neoplastic pathologies associated with gallstones were excluded. Results: During the pre-pandemic period, between March 2019 and March 2020, a total of 408 patients with pancreatobiliary pathology were hospitalized. Out of 408 patients, 204 (50%) were admitted with acute biliary cholecystitis, 132 patients with acute pancreatitis (32.4%), and 72 patients with extrahepatic cholestasis (17.6%). 324 (79%) patients underwent surgery and 36 (8.82%) patients out of the remaining 84 (20.6%) patients were readmitted. The average hospital stay for patients with surgery was 4 days ± 1.6 days, while for those with non-surgical treatment was 7 days ± 1.4 days. From March 2020 to March 2021, a total number of 536 patients were hospitalized, including 252 (47%) with acute biliary cholecystitis, 144 (26.9%) with acute pancreatitis, and 128 (23.9%) with extrahepatic cholestasis and 12 with acute cholangitis (2.2%). 308 (57.5%) patients underwent surgery and 104 (19.4%) patients of the remaining 228 (42.5%) patients were readmitted. The average hospital stay for patients with surgery was 3 days ± 1.3 days, while for those with non-surgical treatment was 7 days ± 1.5 days. Conclusions: The comparison of both groups showed a higher incidence of gallstone complications during the pandemic, associated with the preference of medical over surgical management. The higher incidence of complications were seen and associated with a decrease in the number of scheduled laparoscopic cholecystectomies.

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Cholecystectomy during the COVID-19 pandemic: Current evidence and an understanding of the ‘new’ critical view of safety: Correspondence

Cited by 6 publications

References 11 publications

Laparoscopic cholecystectomy during the COVID-19 pandemic in a tertiary care hospital in Germany: higher rates of acute and gangrenous cholecystitis in elderly patients

Laparoscopic cholecystectomy during the COVID-19 pandemic in a tertiary care hospital in Germany: higher rates of acute and gangrenous cholecystitis in elderly patients

Delivery of digestive surgery services during the COVID‐19 pandemic: Indonesian Society of Digestive Surgeons online survey

Impact of COVID-19 Restrictions on Outcomes of Patients with Cholelithiasis during the Pandemic

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