Donato Giulio, Forti Edoardo, Mutignani Massimiliano, Laterra Maria Antonella, Arese Daniele, Coppola Franco, Zaccari Piera, Mariani Alberto, Arcidiacono Paolo Giorgio, Pigò Flavia, Conigliaro Rita, Costa Deborah, Tringali Alberto, Lavagna Alessandro, Rocca Rodolfo, Gabbiadini Roberto, Fugazza Alessandro, Repici Alessandro, Fava Giammarco, Marini Francesco, Mosca Piergiorgio, Urban Flavia, Monica Fabio, Crinò Stefano Francesco, Gabbrielli Armando, Blois Matteo, Binda Cecilia, Sbrancia Monica, Fabbri Carlo, Frego Roberto, Dinelli Marco, Imbesi Venerina, Gambitta Pietro, Balzarini Marco, Segato Sergio, Grazioli Leonardo Minelli, Spada Cristiano, Amato Arnaldo, Venezia Giovanna, Aragona Giovanni, Rosa Cesare, Alvisi Costanza, Devani Massimo, Manes Gianpiero, Dell'Amico Iginio, Gemme Carlo, Reati Raffaella, Auriemma Francesco, Mangiavillano Benedetto, Rodi Marcello, Bertani Helga, Mazzucco Dario, Armellini Elia, Cantù Paolo, Penagini Roberto, Occhipinti Pietro
Gastroenterology Unit, Department of Oncological and Specialty Medicine, Azienda Ospedaliero-Universitaria Maggiore della Carità, Novara, Italy.
Digestive and Operative Endoscopy Unit, ASST Grande Ospedale Metropolitano Niguarda, Milan, Italy.
Endosc Int Open. 2021 Apr;9(4):E629-E634. doi: 10.1055/a-1380-3419. Epub 2021 Apr 15.
COVID-19 has dramatically impacted endoscopy practice because upper endoscopy procedures can be aerosol-generating. Most elective procedures have been rescheduled. Endoscopic retrograde cholangiopancreatography (ERCP) is frequently performed in emergency or urgent settings in which rescheduling is not possible. We evaluated the impact of the COVID-19 pandemic on ERCP in Italy during the SARS-CoV-2 lockdown, in areas with high incidence of COVID-19. We performed a retrospective survey of centers performing ERCP in high COVID-19 prevalence areas in Italy to collect information regarding clinical data from patients undergoing ERCP, staff, case-volume and organization of endoscopy units from March 8, 2020 to April 30, 2020. We collected data from 31 centers and 804 patients. All centers adopted a triage and/or screening protocol for SARS-CoV-2 and performed follow-up of patients 2 weeks after the procedure. ERCP case-volume was reduced by 44.1 % compared to the respective 2019 timeframe. Of the 804 patients undergoing ERCP, 22 (2.7 %) were positive for COVID-19. Adverse events occurred at a similar rate to previously published data. Of the patients, endoscopists, and nurses, 1.6 %, 11.7 %, and 4.9 %, respectively, tested positive for SARS-CoV-2 at follow up. Only 38.7 % of centers had access to a negative-pressure room for ERCP. The case-volume reduction for ERCP during lockdown was lower than for other gastrointestinal endoscopy procedures. No definitive conclusions can be drawn about the percentage of SARS-CoV-2-positive patients and healthcare workers observed after ERCP. Appropriate triage and screening of patients and adherence to society recommendations are paramount.
2019冠状病毒病（COVID-19）对内镜诊疗实践产生了巨大影响，因为上消化道内镜检查操作可能会产生气溶胶。大多数择期手术已重新安排时间。内镜逆行胰胆管造影术（ERCP）经常在无法重新安排时间的急诊或紧急情况下进行。我们评估了在严重急性呼吸综合征冠状病毒2（SARS-CoV-2）封锁期间，在COVID-19高发病率地区，COVID-19大流行对意大利ERCP的影响。我们对意大利COVID-19高流行地区进行ERCP的中心进行了一项回顾性调查，以收集2020年3月8日至2020年4月30日期间接受ERCP患者的临床数据、工作人员、病例数量以及内镜科室的组织情况等信息。我们收集了31个中心和804例患者的数据。所有中心都采用了针对SARS-CoV-2的分诊和/或筛查方案，并在术后2周对患者进行随访。与2019年同期相比，ERCP病例数量减少了44.1%。在804例接受ERCP的患者中，22例（2.7%）COVID-19检测呈阳性。不良事件发生率与先前公布的数据相似。在患者、内镜医师和护士中，随访时SARS-CoV-2检测呈阳性的比例分别为1.6%、11.7%和4.9%。只有38.7%的中心有用于ERCP的负压室。封锁期间ERCP的病例数量减少幅度低于其他胃肠道内镜检查操作。关于ERCP后观察到的SARS-CoV-2阳性患者和医护人员的比例，无法得出明确结论。对患者进行适当的分诊和筛查以及遵守社会建议至关重要。
