THE IMPACT OF COVID-19 PANDEMIC ON SYMPTOMATIC GALLSTONE DISEASE

Year 2021, Volume: 23 Issue: 3, 462 - 467, 31.12.2021

Serkan Şengül , Hasan Çalış , Yilmaz Güler , Zülfikar Karabulut

https://doi.org/10.24938/kutfd.904795

Abstract

Objective: After the COVID-19 pandemic was declared, many centers made alterations in their routine surgical treatments. In this study, we aimed to compare patients who underwent cholecystectomy for symptomatic gallstone disease during the pandemic and pre-pandemic periods.

Material and Methods: Two groups were formed in this study; the pandemic group consisting of patients with symptomatic gallstone disease who underwent surgery between March 11 2020 and January 31 2020, and the pre-pandemic group consisting of patients who were operated in the same period of 2019. These two groups were compared in terms of demographic data, conversion rates and histopathology results.

Results: A total of 293 patients were included in the study. Two hundred and seven patients took part in the pre-pandemic period and 86 in the pandemic period. The rate of conversion to open cholecystectomy was 2.8% (n=6) in the pre-pandemic group and 6.9% (n=6) in the pandemic group. However, there was no statistically significant difference between the groups in terms of conversion rates (p=0.10). The gallbladder wall thickness was significantly higher in the pandemic group compared to the pre-pandemic group (3.2±1.7 mm vs. 2.7±1.4 mm, p=0.009). In the pandemic group, postoperative pathology was reported as subacute cholecystitis in 19.8% (n=17) of patients. In the pre-pandemic group, this rate was 11.1% (n=23) (p=0.04).

Conclusion: Possible delays in the treatment of patients with symptomatic gallbladder stones during the pandemic period may lead to an increase in factors that may result in conversion to open surgery. However, further studies with large sample size are needed to elucidate this issue.

Keywords

covid-19, pandemic, gallbladder stone, conversion

Semptomatik Safra Kesesi Taşı Hastalığında COVİD-19 Pandemisinin Etkisi

Abstract

Amaç: COVID-19 pandemisi ilan edildikten sonra birçok merkez rutin uygulanan cerrahi tedavilerde değişikliklere gitti. Bu çalışmada semptomatik safra kesesi taşı hastalığı nedeni ile kolesistektomi uygulanan hastaları pandemi ve prepandemi döneminde karşılaştırmayı amaçladık.

Gereç ve Yöntemler: Çalışma için semptomatik safra kesesi taşı hastalığı olan, 11.03.2020-31.12.2020 tarihleri arasında opere edilen hastalardan oluşan pandemi grubu ve 2019 yılının aynı döneminde ameliyat edilen hastalardan oluşan prepandemi grubu olmak üzere iki grup oluşturuldu. Bu iki grup demografik veriler, konversiyon oranları ve patoloji sonuçları açısından karşılaştırıldı.

Bulgular: Toplamda 293 hasta çalışmaya dahil edildi. Bu hastaların 207’si prepandemi döneminde 86’ sı ise pandemi döneminde yer aldı. Prepandemi grubunda açık kolesistektomiye dönen hasta %3 (n=6), pandemi grubunda ise %7 (n=6) olarak bulundu. Ancak konversiyon oranları açısından gruplar arasında anlamlı fark yoktu (p=0,10). Pandemi grubunda kese duvar kalınlığı prepandemi grubuna göre anlamlı olarak yüksek bulundu (3.2±1.7 mm’ye karşı 2.7±1,4 mm, p=0,009). Pandemi grubunda postoperatif patoloji sonucu %20 (n=17) hastada subakut kolesistit olarak raporlandı. Prepandemi grubunda ise bu oran %11 (n=23) olarak bulundu (p=0,04).

Sonuç: Pandemi döneminde semptomatik safra kesesi taşı nedeni olan hastaların tedavilerindeki olası gecikmeler konversiyona neden olabilecek faktörlerde artışa neden olabilir. Ancak bu konuda yüksek sayıda örneklem içeren çalışmalara ihtiyaç duyulmaktadır.

Keywords

covid-19, pandemi, konversiyon, safra kesesi taşı

References

• 1. Li Q, Guan X, Wu P, Wang X, Zhou L, Tong Y et al. Early transmission dynamics in Wuhan, China, of novel coronavirus–infected pneumonia. N Engl J Med. 2020;382(13):1199-207.
• 2. Benvenuto D, Giovanetti M, Ciccozzi A, Spoto S, Angeletti S, Ciccozzi M. The 2019‐new coronavirus epidemic: evidence for virus evolution. J Med Virol. 2020;92(4):455-9.
• 3. Parreira JG, Campos TD, Antunes PDSL, Perlingeiro JAG, Assef JC. Management of non-traumatic surgical emergencies during the COVID-19 pandemia. Rev Col Bras Cir. 2020;47:e20202614.
• 4. Lammert F, Acalovschi M, Ercolani G, van Erpecum KJ, Gurusamy K, van Laarhoven CJ et al. EASL Clinical Practice Guidelines on the prevention, diagnosis and treatment of gallstones. J Hepatol. 2016;65(1):146-81.
• 5. Shabanzadeh DM. Incidence of gallstone disease and complications. Curr Opin Gastroenterol. 2018;34(2):81-9.
• 6. Brazzelli M, Cruickshank M, Kilonzo M, Ahmed I, Stewart F, McNamee P et al. Systematic review of the clinical and cost effectiveness of cholecystectomy versus observation/conservative management for uncomplicated symptomatic gallstones or cholecystitis. Surg Endosc. 2015;29(3):637-47.
• 7. Campanile FC, Podda M, Arezzo A, Botteri E, Sartori A, Guerrieri M et al. Acute cholecystitis during COVID-19 pandemic: a multisocietary position statement. World J Emerg Surg. 2020;15(1):38.
• 8. Moletta L, Pierobon ES, Capovilla G, Costantini M, Salvador R, Merigliano S et al. International guidelines and recommendations for surgery during Covid-19 pandemic: a systematic review. Int J Surg. 2020;79:180-8.
• 9. Ansaloni L, Pisano M, Coccolini F, Peitzmann A, Fingerhut A, Catena F et al. 2016 WSES guidelines on acute calculous cholecystitis. World J Emerg Surg. 2016;11:25.
• 10. Agresta F, Campanile FC, Vettoretto N, Silecchia G, Bergamini C, Maida P et al. Laparoscopic cholecystectomy: consensus conference-based guidelines. Langenbecks Arch Surg. 2015;400(4):429-53.
• 11. Coccolini F, Tartaglia D, Puglisi A, Giordano C, Pistello M, Lodato M et al. SARS-CoV-2 is present in peritoneal fluid in COVID-19 patients. Ann Surg. 2020;272(3):e240-e242.
• 12. Kamer E, Çolak T. What to do when a patient infected with COVID-19 needs an operation: a pre-surgery, peri-surgery and post-surgery guide. Turk J Colorectal Dis. 2020;30(1):1-8.
• 13. 1Avgerinos C, Kelgiorgi D, Touloumis Z, Baltatzi L, Dervenis C. One thousand laparoscopic cholecystectomies in a single surgical unit using the “critical view of safety” technique. J Gastrointest Surg. 2009;13(3):498-503.
• 14. Pavlidis TE, Marakis GN, Ballas K, Symeonidis N, Psarras K, Rafailidis S et al. Risk factors influencing conversion of laparoscopic to open cholecystectomy. J Laparoendosc Adv Surg Tech A. 2007;17(4):414-8.
• 15. Genc V, Sulaimanov M, Cipe G, Basceken SI, Erverdi N, Gurel M et al. What necessitates the conversion to open cholecystectomy? A retrospective analysis of 5164 consecutive laparoscopic operations. Clinics (Sao Paulo). 2011;66(3):417-20.
• 16. Rothman JP, Burcharth J, Pommergaard H-C, Viereck S, Rosenberg J. Preoperative risk factors for conversion of laparoscopic cholecystectomy to open surgery-a systematic review and meta-analysis of observational studies. Dig Surg. 2016;33(5):414-23.
• 17. Low S-W, Iyer SG, Chang SK-Y, Mak KS, Lee VTW, Madhavan K. Laparoscopic cholecystectomy for acute cholecystitis: safe implementation of successful strategies to reduce conversion rates. Surg Endosc. 2009;23(11):2424-9.
• 18. Lei S, Jiang F, Su W, Chen C, Chen J, Mei W et al. Clinical characteristics and outcomes of patients undergoing surgeries during the incubation period of COVID-19 infection. E Clinical Medicine. 2020;21:100331.
• 19. Aminian A, Safari S, Razeghian-Jahromi A, Ghorbani M, Delaney CP. COVID-19 outbreak and surgical practice: unexpected fatality in perioperative period. Ann Surg. 2020;272(1):e27-e29.