Covid-19: A Retrospective Study About The Challenges for ERCP?

Abstract

NTRODUCTION: We aimed to investigate the effects of Covid-19 on Endoscopic retrograde cholangiopancreatography (ERCP) and to investigate what should be considered in the next possible epidemic situations. METHODS: In our study, patients who applied to XXX University School of Medicine, Department of General Surgery for ERCP (Endoscopic retrograde cholangiopancreatography) between March 2019 and March 2021 were evaluated, retrospectively. Percentages, mean, standard deviation, median and interquartile range were used as the descriptive statistics. Mann-Whitney U test was used for the variations which are contrary to the normal distribution range in the comparison of two groups. The relations between qualitative variations were studied by the Pearson Chi-Square test and Fisher's Exact test. Significant value was determined as 0.05 for all statistical analyses. RESULTS: Prior to COVID-19, ERCP indications were in the order of stone (90.1%), stent removal (8%) and tumor (1.1%), while in the period of COVID-19, the ranking changed to stone (73.8%), tumor (13.7%), and stent removal (12.4%).. The diagnostic use of ERCP has been greatly reduced (from 0.7% to 0.0%). No perforation was detected in both periods, there was no bleeding, but a small increase (4.7% to 5.9%) was found in pancreatitis in the COVID-19 period. In the pre-COVID-19 period, stones were detected in 46.2% of the patients and all of them were successfully removed, but during the COVID-19 period, stones were detected in 50.6% of the patients and the stones could not be removed in 1.3% of the patients. DISCUSSION AND CONCLUSION: It was observed that the number of ERCPs decreased due to the delay in admissions to the hospital and the fear of coming to the hospital during the Covid-19 epidemic period, and the number of malignancies diagnosed with ERCP increased in this process. In such epidemic periods, more scheduled health services will provide better results for both patients and health personnel.