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• W3210793794 abstract "Purpose: The outbreak of SARS-CoV2 required changes in hospital and healthcare management. An important part of all of the available resources usually assigned to emergency and elective surgery were reallocated to attend patients with COVID-19. The aim of the study was to assess and compare the epidemiology and the management of acute cholecystitis (AC) before and during the pandemic of SARS-CoV-2. Method: A retrospective study of consecutive patients admitted with the diagnosis of AC 12 months before, and 9 months after the outbreak of the pandemic of COVID19 was conducted (March 2019-January 2021). Demographic, clinical, laboratory, radiological and perioperative data was analyzed. Results: A total of 182 patients were admitted during the period of the study: 135 pre-COVID and 47 during the pandemic. Median age was 72 years and 55.5% were female. The median age adjusted Charlson Comorbidity Index was 4. A decrease in the admissions per month after the COVID19 outbreak was observed (Figure 1), resulting in a 58.6% decrease compared with the same period the previous year. There was a non-significant increase in the number of patients with important comorbidities during the pandemic: hypertension (57.8 vs 63.8%), diabetes (26.7vs 38.8%), cardiopathy (29.6 vs 44.7%), and pneumopathy (20 vs 31.9%). The number of patients with chronic kidney disease was significantly higher after the COVID outbreak (9.6 vs 23.4%, p=0.024). Higher number of patients were admitted during the pandemic with symptoms' duration more than 72 hours without reaching the statistical significance (18.5% vs 29.8%). No other differences in terms of patients’ demographic data, severity of the cholecystitis (Tokyo Guidelines 18), type of treatment (conservative vs surgical/ antibiotherapy vs cholecystostomy/ laparoscopic vs open approach), morbi-mortality, length of hospital stay and cholelithiasis related readmission rate in case of medical treatment were observed (Table 1). Conclusion: There was an important decrease in the volume of patients admitted with acute cholecystitis during the COVID pandemic. Non-significant increase of patients with relevant comorbidities was noted. No significant differences in the severity and the management of the patients pre-COVID and during the pandemic were observed.EP271_Table 1Characteristics of patients treated for acute cholecystitis before and during the COVID pandemic.Pre-Covid period n= 135Covid period n= 47PAge (years)72 (55-82)72 (57-86)0.333Gender Female73 (54.1%)28 (59.6%)0.610 Male62 (45.9%)19 (40.4%)Comorbidities: Hypertension78 (57.8%)30 (63.8%)0.495 Diabetes36 (26.7%)18 (38.8%)0.142 Pneumopathy27 (20.0%)15 (31.9%)0.109 Cardiopathy40 (29.6%)21 (44.7%)0.073 Chronic kidney disease13 (9.6%)11 (23.4%)0.024Age Adjusted Charlson Comorbidity Index4 (2-5)4(2-6)0.173Duration of symptoms <72 hours110 (81.5%)33 (70.2%)0.147 > 72 hours25 (18.5%)14 (29.8%)Tokyo Guidelines 18 Classification Grade I -II122 (90.4%)42 (89.4%)0.784 Grade III13 (9.6%)5 (10.6%)Leukocytes13400 (10200-18400)15300 (11600-17575)0.086Neutrophils10414 (7690-15566)12645 (8747-15653)0.137C reactive protein (mg/dl)7.40 (1.91-17.14)5.93 (0.97-14.58)0.866Bilirubin (mg/dl)1.00 (1.00-1.00)1.00 (0.98-1.83)0.808Creatinine (mg/dl)1.03 (0.85-1.32)0.93 (0.69-1.22)0.372Treatment: Conservative/Surgical55/80 (40.7%/59.3%)23/24 (48.9%/51.1%)0.393 Conservative treatment:Cholecystostomy/ ATB10/45 (8.2%/81.8 %)3/20 (13.0%/87.0%)0.425 Surgical treatment:Laparoscopic/ Open surgery64/16 (80%/20%)22/2 (91.7%/8.3%)0.233Postoperative Morbidity7 (8.8%)2 (8.7%)1.000Clavien-Dindo grade ≤ 22 (28.6%)1 (50.0%)1.000Clavien-Dindo grade ≥ 35 (71.4%)1 (50.0%)Clavien-Dindo Grade 11 (14.3%)0 (0%) Grade 21 (14.3%)1 (50%) Grade 3a3 (42.9%)0 (0%) Grade 3b1 (14.3%)1 (50%) Grade 41 (14.3%)0 (0%)Mortality0 (0%)1 (2.1%)0.258Cholelithiasis related readmission after conservative treatment26 (19.3%)7 (14.9%)0.661Length of hospital stay (days)4 (3-7)5(3-8)0.398 Open table in a new tab" @default.
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• W3210793794 date "2021-01-01" @default.
• W3210793794 modified "2023-09-27" @default.
• W3210793794 title "Impact of COVID-19 pandemic on epidemiology and management of acute cholecystitis" @default.
• W3210793794 doi "https://doi.org/10.1016/j.hpb.2021.08.614" @default.
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