ABSTRACT
Aim: In April 2020 routine elective surgery in England was suspended in response to coronavirus disease-2019 (COVID-19). Low COVID-19 infection and mortality rates in the South West of England allowed urgent elective surgery in Plymouth to continue with the necessary precautions. The aim of this study was to assess outcomes following elective laparoscopic cholecystectomy during the initial phase of the COVID-19 pandemic. Materials and methods: Records of 54 consecutive patients undergoing urgent elective laparoscopic cholecystectomy between March 25, 2020, and June 25, 2020, were analyzed retrospectively. Patients were telephoned after 30 days. All patients underwent COVID-19 swab testing 24 to 72 hours prior to surgery and during admission if clinically indicated. The primary outcome measure was COVID-19 related morbidity. Secondary outcome measures were non-COVID-19 related morbidity, mortality, and length of hospital stay. Results: Fifty-four patients [19 male, 35 female;median age 59 years (20–79);median body mass index (BMI) 31 kg/m2 (22.9–46.8);median ASA 2] underwent laparoscopic cholecystectomy during the study period. Fifty-one patients (94%) were of White-British ethnicity. One patient tested positive for COVID-19 preoperatively. There were no COVID-19 diagnoses postoperatively and no COVID-19 related morbidity. There were no deaths at 30 days. Forty-four patients (81%) had a day-case procedure. Forty-two (78%) procedures were performed by a supervised trainee. Conclusion: Elective laparoscopic cholecystectomy can be performed safely and training maintained in areas of low COVID-19 prevalence with the necessary precautions. Clinical significance: This small study provides some evidence to aid decision-making around the provision of elective surgical services during this ongoing pandemic.
ABSTRACT
Background: Elective surgery, especially bariatric surgery, was stopped during the coronavirus disease-2019 (COVID-19) pandemic in the United Kingdom. Obesity is a major risk factor for COVID-19-related mortality. As the COVID-19 infection and mortality rates in Devon had been relatively low, bariatric procedures resumed with the necessary precautions in Plymouth with the easing of lockdown restrictions in mid-May. The aim of this study was to examine the outcome of bariatric surgery during the COVID-19 pandemic. Methods: Details of 38 patients, who underwent bariatric surgery between June 2020 and November 2020, were analyzed prospectively. All patients underwent a COVID-19 swab test 24–48 hours prior to the surgery. The primary outcome measure was COVID-19-related morbidity. Secondary outcomes were non-COVID-19-related morbidity, mortality, and weight loss at 6-week follow-up. Results: Thirty-eight patients [24 females;median age 51 (24–63) years, median body mass indices (BMI) at surgery 42.9 (32.4–62.5) kg/m2] underwent bariatric surgery. Thirty-seven patients were of White British ethnicity. No patient tested positive for COVID-19 pre-and postoperatively. No patient had any COVID-19-related morbidity or mortality. One patient developed a staple line bleed and returned to theater for relook laparoscopy and hemostasis. One patient developed an anastomotic leak and had a relook laparotomy for lavage and drain placement. The median length of hospital stay was 1 day. One patient was preplanned for intensive care admission and he stayed in a high dependency unit (HDU) for 1 day. All patients were followed up for 6 weeks and the median (range) excess weight loss (%EWL), at 6 weeks, was 24.4% (−0.9–53.6). Conclusion: Bariatric surgery can be performed safely in an area of low COVID-19 prevalence with the necessary precautions.