Patel Maitreyi S, Thomas Joel J, Aguayo Xavier, Chaloupkova Dita, Sivapregasm Princely, Uba Vivian, Sarwary Sayed Haschmat
General Surgery, Barking, Havering and Redbridge University Hospitals NHS Trust, Romford, GBR.
Surgery, Barking, Havering and Redbridge University Hospitals NHS Trust, Romford, GBR.
Cureus. 2022 Jun 22;14(6):e26198. doi: 10.7759/cureus.26198. eCollection 2022 Jun.
Introduction This study aims to compare the patient demographics and management of acute manifestations of gallstone disease during the COVID-19 pandemic with an equivalent period in 2019 and assess the differences in recurrence patterns throughout the first and second waves of the pandemic in the UK. Methods A retrospective cohort study of all adult patients aged >16 years presenting to the emergency department at a large District General Hospital with symptoms related to gallstones. Data were obtained from electronic patient records. The primary outcomes were incidence and management of gallstone disease, while secondary outcomes studied included length of stay, readmission rate, and recurrence. Data were tabulated and analyzed using Excel (Microsoft, 2016 version). Chi-square and t-test were used as appropriate. One way ANOVA test was used to compare data of three groups. Results Fifty-one patients presented during the period of first-wave and 105 patients during the second wave as compared to 71 patients in the study period in 2019. The median age of patients during the first wave of COVID was significantly higher than pre-COVID in the second wave. During both the waves of the pandemic, there was no significant difference in patients presenting with cholecystitis compared with 2019 (47 and 94 in the first and second wave, respectively, versus 60 in 2019; p-value 0.39). There was no significant increase in the use of cholecystostomy, and the use of radiological investigations was comparable. There was no significant difference in recurrence and readmissions. The majority of the patients still await surgery. Conclusion During the pandemic, older patients with higher co-morbidity presented with acute gallstone disease. Conservative management was effective in the management of these patients.
引言 本研究旨在比较2019年同期与新冠疫情期间胆结石疾病急性表现的患者人口统计学特征及管理情况，并评估英国疫情第一波和第二波期间复发模式的差异。方法 对一家大型区综合医院急诊科收治的所有年龄大于16岁、出现与胆结石相关症状的成年患者进行回顾性队列研究。数据从电子病历中获取。主要结局为胆结石疾病的发病率及管理情况，次要结局包括住院时间、再入院率和复发情况。数据使用Excel（微软，2016版）制表并分析。适当使用卡方检验和t检验。采用单因素方差分析检验比较三组数据。结果 与2019年研究期间的71例患者相比，第一波期间有51例患者就诊，第二波期间有105例患者就诊。新冠疫情第一波期间患者的中位年龄显著高于第二波疫情前。在疫情的两波期间，与2019年相比，胆囊炎患者人数无显著差异（第一波和第二波分别为47例和94例，2019年为60例；p值为0.39）。胆囊造瘘术的使用没有显著增加，放射学检查的使用情况相当。复发率和再入院率无显著差异。大多数患者仍在等待手术。结论 在疫情期间，合并症较多的老年患者出现急性胆结石疾病。保守治疗对这些患者有效。
