Gastroenterology and Hepatology, Qena University Hospital. Qena Faculty of Medicine, Egypt.
General Surgery , Qena University Hospital.
Rev Esp Enferm Dig. 2022 Aug;114(8):455-460. doi: 10.17235/reed.2021.8229/2021.
the COVID-19 pandemic has impacted on several aspects of health care services worldwide. The aim of the study was to determine its influence on the case volume, success rate and complication rate of endoscopic retrograde cholangiopancreatography (ERCP).
all patients who underwent ERCP one-year before and after applying COVID-19 safety measures at the Qena University Hospital were included. Data were collected from the patients' records, analyzed and compared.
a total of 250 patients underwent ERCP between April 1st, 2019 and March 31st, 2021, and the mean age of participants was 52 ± 18 years. There was a 5 % increase in case volume after applying COVID-19 safety measures (128 vs 122) and the total procedure time was significantly shorter (42 vs 46 minutes, p = 0.04). There was no significant difference in the overall success rate and complication rate. Procedure success significantly correlated with cannulation attempts and total procedure time in both groups, and serum bilirubin and cannulation time in the pre-COVID-19 patients and alkaline phosphatase (ALP) in post-COVID patients. ERCP-related complications significantly correlated with cannulation attempts in both groups, and ALP, international normalized ratio (INR), cannulation time and total procedure time in pre-COVID-19 patients, and platelet count and amylase in post-COVID patients. Two patients were confirmed COVID-19 cases at the time of ERCP; therapeutic targets were achieved in both with a smooth post-ERCP recovery. Three out of nine ERCP team members caught a mild to moderate COVID-19 infection and recovered after receiving proper management.
our result show that there was no negative impact of using COVID-19 safety measures and precautions on the case-volume, indications, overall outcome or complication rate of ERCP.
COVID-19 大流行对全球医疗服务的几个方面都产生了影响。本研究旨在确定其对内镜逆行胰胆管造影术(ERCP)的病例数量、成功率和并发症发生率的影响。
所有在 2019 年 4 月 1 日至 2021 年 3 月 31 日期间在基纳大学医院应用 COVID-19 安全措施前后接受 ERCP 的患者均被纳入研究。从患者记录中收集数据并进行分析和比较。
共 250 例患者接受了 ERCP,应用 COVID-19 安全措施后病例数量增加了 5%(128 例比 122 例),总手术时间明显缩短(42 分钟比 46 分钟,p=0.04)。总的成功率和并发症发生率无显著差异。在两组中,手术成功率与尝试插管次数和总手术时间显著相关,在 COVID-19 前患者中与血清胆红素和插管时间相关,在 COVID-19 后患者中与碱性磷酸酶(ALP)相关。ERCP 相关并发症与两组中的插管尝试次数显著相关,在 COVID-19 前患者中与 ALP、国际标准化比值(INR)、插管时间和总手术时间相关,在 COVID-19 后患者中与血小板计数和淀粉酶相关。有 2 例患者在 ERCP 时确诊为 COVID-19 病例,均通过治疗实现了目标,并在 ERCP 后顺利康复。9 名 ERCP 团队成员中有 3 人感染了轻度至中度 COVID-19,经过适当的管理后康复。
我们的结果表明,应用 COVID-19 安全措施和预防措施对 ERCP 的病例量、适应证、总体结果或并发症发生率没有负面影响。