Hanatani Jun-Ichi, Kitagawa Koh, Tomooka Fumimasa, Asada Shohei, Mitoro Akira, Fujinaga Yukihisa, Nishimura Norihisa, Sato Shinya, Shibamoto Akihiko, Fujimoto Yuki, Kubo Takahiro, Iwai Satoshi, Tsuji Yuki, Namisaki Tadashi, Akahane Takemi, Kaji Kosuke, Tanaka Misako, Koizumi Aritoshi, Yorioka Nobuyuki, Matsuda Takuya, Masuda Hiroyuki, Takami Masayoshi, Kikuchi Mayuko, Kawanishi Mariya, Ohoka Kazutaka, Watanabe Daisuke, Kawasaki Akane, Yoshiji Hitoshi
Department of Gastroenterology Nara Medical University Nara Japan.
Division of Endoscopy Nara Medical University Nara Japan.
DEN Open. 2024 Apr 30;5(1):e371. doi: 10.1002/deo2.371. eCollection 2025 Apr.
This study aimed to determine the impact of the coronavirus disease 2019 (COVID-19) pandemic on the treatment of acute cholangitis caused by choledocholithiasis.
The Japanese government declared a state of emergency in April 2020 due to the COVID-19 pandemic. We retrospectively reviewed the medical records of 309 patients who underwent endoscopic retrograde cholangiopancreatography (ERCP) for acute cholangitis caused by choledocholithiasis between April 2017 and December 2022.
Patients were categorized into a pregroup ( = 134) and a postgroup ( = 175), depending on whether they were diagnosed before or after the state of emergency declaration. The total number of ERCP cases and the number of ERCP cases with endoscopic stone removals increased after the state of emergency declaration. Compared with the pregroup, the numbers of patients with performance status of 0-1 and surgically altered anatomy increased, whereas the numbers of patients taking oral antiplatelets or anticoagulants and those with cerebrovascular disease decreased in the postgroup. The number of single-stage endoscopic stone removals increased and hospital stays were significantly shorter in the postgroup. No differences in adverse event rates were detected between the two groups.
Although our hospital provides tertiary care, the number of patients with cholangitis in good general condition and no underlying disease increased after the state of emergency declaration. The COVID-19 pandemic resulted in an increase in the number of single-stage endoscopic treatments and shortened hospital stays for patients with acute cholangitis caused by choledocholithiasis. No safety issues with ERCP were detected, even during the pandemic.
本研究旨在确定2019冠状病毒病（COVID-19）大流行对胆总管结石所致急性胆管炎治疗的影响。
由于COVID-19大流行，日本政府于2020年4月宣布进入紧急状态。我们回顾性分析了2017年4月至2022年12月期间因胆总管结石所致急性胆管炎接受内镜逆行胰胆管造影（ERCP）的309例患者的病历。
根据患者是在紧急状态声明之前还是之后被诊断，将其分为术前组（n = 134）和术后组（n = 175）。紧急状态声明后，ERCP病例总数和进行内镜下取石的ERCP病例数有所增加。与术前组相比，术后组中表现状态为0-1且解剖结构有手术改变的患者数量增加，而服用口服抗血小板药物或抗凝剂的患者以及患有脑血管疾病的患者数量减少。术后组单阶段内镜下取石的数量增加，住院时间显著缩短。两组之间未检测到不良事件发生率的差异。
尽管我们医院提供三级护理，但紧急状态声明后，一般状况良好且无基础疾病的胆管炎患者数量有所增加。COVID-19大流行导致胆总管结石所致急性胆管炎患者的单阶段内镜治疗数量增加，住院时间缩短。即使在大流行期间，也未检测到ERCP的安全问题。
