The impact of COVID-19 on emergency cholecystectomy.

Autor: Ma JLG; Department of Surgery, Frankston Hospital, Frankston, Victoria, Australia., Yogaraj V; Faculty of Medicine, Monash University, Clayton, Victoria, Australia., Siddiqui M; Faculty of Medicine, Monash University, Clayton, Victoria, Australia., Chauhan K; Faculty of Medicine, Monash University, Clayton, Victoria, Australia., Tobin VA; Department of Surgery, Frankston Hospital, Frankston, Victoria, Australia., Pilgrim CHC; Department of Surgery, Frankston Hospital, Frankston, Victoria, Australia.
Jazyk: angličtina
Zdroj: ANZ journal of surgery [ANZ J Surg] 2022 Mar; Vol. 92 (3), pp. 409-413. Date of Electronic Publication: 2021 Dec 02.
DOI: 10.1111/ans.17406
Abstrakt: Backgrounds: The impact of the SARS-CoV-2 virus (COVID-19) upon the delivery of surgical services in Australia has not been well characterized, other than restrictions to elective surgery due to government directive-related cancellations. Using emergency cholecystectomy as a representative operation, this study aimed to investigate the impact of COVID-19 on emergency general surgery in Australia in relation to in-hours versus after-hours operating.
Methods: A retrospective analysis was conducted of medical records for patients admitted with cholecystitis or biliary colic between 1 March 2019 and 28 February 2021 at Frankston Hospital, Australia. Patient demographics, admission data, imaging findings, operative and post-operative data were compared between pre-COVID-19 and COVID-19 periods. Variables were compared using the Wilcoxon-Mann-Whitney, Chi Squared or Fishers exact test.
Results: During the COVID-19 period, emergency cholecystectomy was performed for a greater proportion of patients presenting with cholecystitis or biliary colic (93.5% versus 77.7%, p < 0.01). Despite this, there was concomitant reduction in after-hours cholecystectomy from 14.4% to 7.5% (p = 0.04). Patients requiring after-hours surgery during the COVID-19 period had more features of sepsis (23% more tachypnoeic, 18% more hypotensive), and were more likely to have certain features of cholecystitis on imaging (45% more likely to have pericholecystic fluid).
Conclusion: Following elective surgery cancellations during the COVID-19 period, an increase was seen in the proportion of patients presenting with gallstone disease who were managed with emergency cholecystectomy due to improved theatre access. Concurrently, there was a decrease in the requirement for surgery to be performed after-hours.
(© 2021 Royal Australasian College of Surgeons.)
Databáze: MEDLINE
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