Multicentre cohort study of acute cholecystitis management during the COVID-19 pandemic

Caballero, Javier Martínez; González, Lucı́a; Cuéllar, Elías Rodríguez; Herrero, Eduardo Ferrero; Algar, Cristina Pérez; Jodra, Víctor Vaello; Díaz, María Dolores Pérez; Dziaková, Jana; Romanillos, R San Roman; Martino, Marcello Di; Rodríguez, Ángela de la Hoz; Martín, Mónica Galán; López, Daniel Sánchez; Virosta, Mariana García; Bartolomé, Marta de la Fuente; Lama, María de Mar Pardo de; Pérez, David Díaz; Jiménez, David; Navas, Luis de Nicolás; Alegre, J.J.; García, Javier García-Quijada; Guevara-Martínez, Jenny; Villadoniga, Arantxa; Fernández, Roberto Martínez

doi:10.1007/s00068-021-01631-1

Cited by 16 publications

(15 citation statements)

References 22 publications

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“…The significant decrease in the number of cholecystectomies in the present study is in line with an international survey including 14 countries [ 25 ], where the majority (72%) of hepato-pancreato-biliary surgeons reported an “alarming decrease” in the number of cholecystectomies during the pandemic. An increase in non-surgical treatment for acute cholecystitis was also reported by multicenter studies from the U.K. and Spain [ 26 , 27 ], although a multisocietary position statement concluded that laparoscopic cholecystectomy remains the treatment of choice for acute cholecystitis even during the COVID-19 pandemic [ 28 ]. Whether the choice of non-surgical treatment for complicated gallstone disease negatively impacted the outcomes of patients warrants further investigation.…”

Section: Discussionmentioning

confidence: 99%

The impact of COVID-19 on surgical procedures in Japan: analysis of data from the National Clinical Database

et al. 2021

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Background and purpose The spread of COVID-19 has restricted the delivery of standard medical care to surgical patients dramatically. Surgical triage is performed by considering the type of disease, its severity, the urgency for surgery, and the condition of the patient, in addition to the scale of infectious outbreaks in the region. The purpose of this study was to evaluate the impact of the COVID-19 pandemic on the number of surgical procedures performed and whether the effects were more prominent during certain periods of widespread infection and in the affected regions. Methods We selected 20 of the most common procedures from each surgical field and compared the weekly numbers of each operation performed in 2020 with the respective numbers in 2018 and 2019, as recorded in the National Clinical Database (NCD). The surgical status during the COVID-19 pandemic as well as the relationship between surgical volume and the degree of regional infection were analyzed extensively. Results The rate of decline in surgery was at most 10–15%. Although the numbers of most oncological and cardiovascular procedures decreased in 2020, there was no significant change in the numbers of pancreaticoduodenectomy and aortic replacement procedures performed in the same period. Conclusion The numbers of most surgical procedures decreased in 2020 as a result of the COVID-19 pandemic; however, the precise impact of surgical triage on decrease in detection of disease warrants further investigation.

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Section: Discussionmentioning

confidence: 99%

The impact of COVID-19 on surgical procedures in Japan: analysis of data from the National Clinical Database

et al. 2021

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“…The standard treatment for acute cholecystitis is laparoscopic cholecystectomy, and conservative treatment, such as percutaneous cholecystostomy, can be performed in patients in the high-risk group for surgery. However, during the pandemic period, percutaneous cholecystostomy was preferred, in order to avoid laparoscopic surgery, even if the patient was not in a poor general condition ( 34 – 36 ).…”

Section: Discussionmentioning

confidence: 99%

The Impact of the Coronavirus Disease - 19 Pandemic on the Clinical Characteristics and Treatment of Adult Patients with Acute Appendicitis

Kim

Jang

et al. 2022

Front. Surg.

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PurposeThis study aimed to investigate the characteristics, severity, and treatment of adult patients with acute appendicitis in Korea over a 2-year period during the coronavirus disease (COVID-19) pandemic compared to those before the pandemic. We also investigated whether there were any changes in clinical characteristics of acute appendicitis before and after vaccination against the coronavirus.MethodsWe retrospectively reviewed the medical records of patients who were diagnosed with acute appendicitis at our institution between March 1, 2019, and August 31, 2021. We divided the patients into three groups (pre-pandemic, before vaccination, and after vaccination) and analyzed the clinical outcomes.ResultsThe time from symptom onset to hospital arrival and the time from symptom onset to operation increased during the COVID-19 pandemic period compared to the pre-pandemic period. The rate of complicated appendicitis during the pandemic was higher than that before the pandemic. In addition, the number of new daily cases showed a positive correlation with the time from symptom onset to hospital arrival (OR, 0.03; 95% CI, 0.02 to 0.04; P < 0.001) and complicated appendicitis (OR, 1.002; 95% CI, 1.001–1.002; P = 0.0017). The vaccination rate showed a negative correlation with the time from symptom onset to hospital arrival (OR, −2.26; 95% CI, −3.42 to −1.11; P < 0.001) and complicated appendicitis (OR, 0.915; 95% CI, 0.84 to 0.996; P = 0.0404).ConclusionsEmploying hospital-wide efforts, such as screening by rapid PCR testing, to avoid further time delays, and nationwide efforts, such as vaccination, to shorten the time from symptom onset to hospital arrival, are necessary to maintain the quality of treatment of acute appendicitis during an infectious disease pandemic.

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“…This approach consisted of either conservative management and sole use of antibiotics for 127 (58%) patients or PC for 33 (15%) patients. Martínez Caballero et al ( 18 ) did not report exact numbers on all three categories, but it clearly indicates a shift toward conservative management. On the other hand, surgery was the selected approach for 139/475 patients (29.2%).…”

Section: Resultsmentioning

confidence: 98%

COVID-19 and Acute Cholecystitis Management: A Systematic Review of Current Literature

et al. 2022

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IntroductionSince the beginning of the COVID-19 pandemic, many patients with clinically acute presentations have been approached differently. The fear of viral transmission along with the short period of study made patients delay their hospital visits and doctors reassess the approach of certain acute situations. This study aimed to assess the changes in the management of patients with acute cholecystitis before and during COVID-19.MethodsA systematic review of the literature using PubMed (MEDLINE), Scopus, and ScienceDirect databases was performed until 01 September 2021. Totally, two kinds of studies were included, those assessing the management of acute cholecystitis during COVID-19 and those comparing the periods before and during the pandemic. The outcomes recorded include management approaches, complications, and mean length of stay.ResultsA number of 15 eligible articles were included in the study. During the pandemic, six studies revealed a shift toward conservative management of acute cholecystitis and five of them reported that conservative management was opted in 73% of the patients. On the contrary, data from all studies revealed that the surgical approach was preferred in only 29.2% of patients. Furthermore, when comparing the periods before vs. during COVID-19, the conservative approach was reported in 36.3 and 43.2% before vs. during COVID-19, respectively, whereas surgical intervention was performed in 62.5% of patients before COVID-19 and 55.3% during the pandemic. The length of stay was delayed when a non-surgical approach was selected in most studies. Complications, mainly classified by the Clavien-Dindo scale, were higher in the pandemic period.ConclusionA tendency toward more conservative approaches was observed in most studies, reversing the previously used surgical approach in most cases of acute cholecystitis. In most of the examined cases during the COVID-19 pandemic, antibiotic treatment and percutaneous cholecystostomy were much more considered and even preferred.

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Multicentre cohort study of acute cholecystitis management during the COVID-19 pandemic

Cited by 16 publications

References 22 publications

The impact of COVID-19 on surgical procedures in Japan: analysis of data from the National Clinical Database

The impact of COVID-19 on surgical procedures in Japan: analysis of data from the National Clinical Database

The Impact of the Coronavirus Disease - 19 Pandemic on the Clinical Characteristics and Treatment of Adult Patients with Acute Appendicitis

COVID-19 and Acute Cholecystitis Management: A Systematic Review of Current Literature

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