Management and outcomes of gallstone disease during the SARS-COV-2 Coronavirus pandemic

Aims The aim of this study was 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 over the period of first and second wave of the pandemic. 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 was conducted. Data was obtained from electronic patient records. Primary outcome assessed were incidence and management of gallstone disease while secondary outcome studied included length of Stay, re-admission rate and recurrence. Data was tabulated and analyzed using Excel (Microsoft, 2016 version). Chi square, t-test and One way ANOVA tests were used. Results 51 patients presented during the period of first wave and 105 patients during second wave as compared to 71 patients in the study period during 2019. The median age of patients during the first wave of COVID was significantly higher than pre COVID and that in second wave. During both the waves of the pandemic, there was a no significant difference in patients presenting with cholecystitis compared with 2019 (47 and 94 versus 60;p value 0.39). There was no significant increase in use of cholecystostomy. There was no significant difference in recurrence and readmissions. Majority of the patients still await surgery. Conclusion During the pandemic, older patients with higher comorbidity presented with acute gallstone disease. Conservative management was effective in the management of these patients.

Outcomes of Acute Gallstone Disease During the COVID-19 Pandemic: Lessons Learnt.

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.