Increased incidence of gallbladder dysplasia and cancer during COVID19 pandemic

ABSTRACT

Aims Cholecystectomy is one of the most frequently performed operations in the United Kingdom. Following the spread of COVID19 infection, reduced operational capacity has led to lengthen the waiting time for cholecystectomy, which leads to significant readmission rate, growing financial burden and increased complexity of the surgical intervention. Our study aims to identify changes in gallbladder (GB) histopathological findings before and during COVID19 pandemic. Methods Data was collected retrospectively on 337 patients who underwent cholecystectomy between 01/2019–12/2019 (pre-COVID19) and 296 patients between 09/2020–10/2021 (during COVID19) at Princess Alexandra Hospital, including preoperative clinical-radiological, surgery waiting time, operation details, postoperative histology and complications. Statistical analysis performed using chi-square tests (p-value<0.001). Results A total of 2 (0.6%) female cases (average age 75.6) had gallbladder dysplasia (GD) and 1 of them had GB adenocarcinoma found pre-COVID19 versus 8 (2.7%) (7F1M, average age 46.6) with GD and 5 (1.7%) (3F2M, average age 72.6) with adenocarcinoma during pandemic. Other histopathological findings were 153 (45.4%) GB with chronic inflammation, 2 (0.5%) with necrosis or perforation pre-COVID19 versus 127 (42.9%) and 6 (2%) respectively during pandemic. The average surgery waiting time for patients with GD or adenocarcinoma was 135 days before COVID19 versus 224.21 (33–676) during pandemic. Conclusions GD is associated with increased cancer risk at GB and other biliary tract sites. Our data demonstrated a statistically significant increase of incidence of GD and adenocarcinoma (p-value<0.00089) in patients who underwent cholecystectomy during pandemic versus pre-COVID19. Further ongoing study is recommended to understand the correlation with prolonged surgery waiting time.