TY - JOUR
T1 - Global management of a common, underrated surgical task during the COVID-19 pandemic
T2 - Gallstone disease - An international survery
AU - Manzia, Tommaso Maria
AU - Angelico, Roberta
AU - Parente, Alessandro
AU - Muiesan, Paolo
AU - Tisone, Giuseppe
AU - MEGAVID (ManagEment of GAllstone disease during coVID-19 pandemic) Clinical Investigator Group
AU - Al Alawy, Yousef
AU - Arif, Abdul Jabba
AU - Attia, Magdy
AU - Bhati, Chandra
AU - Battula R, Narendra
AU - Bonney, Glenn Kunnath
AU - Brooke-Smith, Mark
AU - Derosas, Carlos
AU - De Liguori Carino, Nicola
AU - Ferretti, Stefano
AU - Fiorani, Cristina
AU - Gherardi, Dario
AU - Hegab, Bassem
AU - Hussain, Zaki
AU - Ielpo, Benedetto
AU - Iesari, Samuele
AU - Lai, Quirino
AU - Lainas, Panagiotis
AU - Lauterio, Andrea
AU - Lazzaro, Alessandra
AU - Marudanayagam, Ravi
AU - Nasralla, David
AU - Nicolini, Daniele
AU - Orlando, Giuseppe
AU - Patrono, Damiano
AU - Pitchaimuthu, Maheswaran
AU - Polak, Wojciech
AU - Quinto, Alberto Marcacuzco
AU - Rai, Rakesh
AU - Scalera, Irene
AU - Schlegel, Andrea
AU - Shanmugam, Vivek
AU - Vitale, Alessandro
AU - Widmer, Jeannette
AU - Yannick, Deswysen
PY - 2020/9
Y1 - 2020/9
N2 - Background: Since the Coronavirus disease-19(COVID-19) pandemic, the healthcare systems are reallocating their medical resources, with consequent narrowed access to elective surgery for benign conditions such as gallstone disease(GD). This survey represents an overview of the current policies regarding the surgical management of patients with GD during the COVID-19 pandemic. Methods: A Web-based survey was conducted among 36 Hepato-Prancreato-Biliary surgeons from 14 Countries. Through a 17-item questionnaire, participants were asked about the local management of patients with GD since the start of the COVID-19 pandemic. Results: The majority (n = 26,72.2%) of surgeons reported an alarming decrease in the cholecystectomy rate for GD since the start of the pandemic, regardless of the Country: 19(52.7%) didn't operate any GD, 7(19.4%) reduced their surgical activity by 50–75%, 10(27.8%) by 25–50%, 1(2.8%) maintained regular activity. Currently, only patients with GD complications are operated. Thirty-two (88.9%) participants expect these changes to last for at least 3 months. In 15(41.6%) Centers, patients are currently being screened for SARS-CoV-2 infection before cholecystectomy [in 10(27.8%) Centers only in the presence of suspected infection, in 5(13.9%) routinely]. The majority of surgeons (n = 29,80.6%) have adopted a laparoscopic approach as standard surgery, 5(13.9%) perform open cholecystectomy in patients with known/suspected SARS-CoV-2 infection, and 2(5.6%) in all patients. Conclusion: In the ongoing COVID-19 emergency, the surgical treatment of GD is postponed, resulting in a huge number of untreated patients who could develop severe morbidity. Updated guidelines and dedicated pathways for patients with benign disease awaiting elective surgery are mandatory to prevent further aggravation of the overloaded healthcare systems.
AB - Background: Since the Coronavirus disease-19(COVID-19) pandemic, the healthcare systems are reallocating their medical resources, with consequent narrowed access to elective surgery for benign conditions such as gallstone disease(GD). This survey represents an overview of the current policies regarding the surgical management of patients with GD during the COVID-19 pandemic. Methods: A Web-based survey was conducted among 36 Hepato-Prancreato-Biliary surgeons from 14 Countries. Through a 17-item questionnaire, participants were asked about the local management of patients with GD since the start of the COVID-19 pandemic. Results: The majority (n = 26,72.2%) of surgeons reported an alarming decrease in the cholecystectomy rate for GD since the start of the pandemic, regardless of the Country: 19(52.7%) didn't operate any GD, 7(19.4%) reduced their surgical activity by 50–75%, 10(27.8%) by 25–50%, 1(2.8%) maintained regular activity. Currently, only patients with GD complications are operated. Thirty-two (88.9%) participants expect these changes to last for at least 3 months. In 15(41.6%) Centers, patients are currently being screened for SARS-CoV-2 infection before cholecystectomy [in 10(27.8%) Centers only in the presence of suspected infection, in 5(13.9%) routinely]. The majority of surgeons (n = 29,80.6%) have adopted a laparoscopic approach as standard surgery, 5(13.9%) perform open cholecystectomy in patients with known/suspected SARS-CoV-2 infection, and 2(5.6%) in all patients. Conclusion: In the ongoing COVID-19 emergency, the surgical treatment of GD is postponed, resulting in a huge number of untreated patients who could develop severe morbidity. Updated guidelines and dedicated pathways for patients with benign disease awaiting elective surgery are mandatory to prevent further aggravation of the overloaded healthcare systems.
KW - Cholecystectomy
KW - COVID-19 pandemic
KW - Elective surgery
KW - Gallstone disease
KW - SARS-CoV-2
UR - http://www.scopus.com/inward/record.url?scp=85088249076&partnerID=8YFLogxK
U2 - 10.1016/j.amsu.2020.07.021
DO - 10.1016/j.amsu.2020.07.021
M3 - Article
AN - SCOPUS:85088249076
SN - 2049-0801
VL - 57
SP - 95
EP - 102
JO - Annals of Medicine and Surgery
JF - Annals of Medicine and Surgery
ER -