The impact of CoVD-19 on the Surgical management of acute cholecystitis

ABSTRACT

Aim: The Association of Upper Gastrointestinal Surgeons (AUGIS) recommends performing a laparoscopic cholecystectomy within 72 hours of admission for acute cholecystitis. COVID-19 has drastically affected The way healthcare is able to be delivered worldwide. This project was designed to audit The impact of COVID-19 on The Surgical management of acute cholecystitis against AUGIS guidelines. Method(s) All General Surgical admission from November 2020 were retrospectively analysed. Admission records were screened for those presenting with acute cholecystitis. Those identified had their records analysed for laparoscopic cholecystectomy. Patients who died before surgery, had an alternative procedure performed, or who were unfit for surgery, were excluded. Result(s) During this time, 28 patients were admitted with acute cholecystitis. In total, 3 patients were excluded 1 died before any possible intervention, 1 was unfit for surgery, and 1 received a cholecystostomy. of The 25 included patients, only 11% (n=3) patients received a laparoscopic cholecystectomy within seven days from their hospital admission. The remaining 89% (n=22) of patients were managed conservatively with fluids, analgesia, and antibiotics. Conclusion(s) It can be concluded that COVID-19 has severely impacted The Surgical management of acute cholecystitis as only 11% of those patients presenting were managed in accordance with AUGIS guidelines. Whether conservative management is an alternative long-term option for management remains to be seen as further long-term studies are needed.