Management of patients at the hepatopancreatobiliary unit of a London teaching hospital during the COVID-19 pandemic

Author:

Staubli Sebastian M.,Raptis Dimitri A.,Ghani Shahi,Davidson Brian R.,Fusai Giuseppe K.,Imber Charles,Iype Sateesh,Nasralla David,Pissanou Theodora,Rahman Sakhawat,Sharma Dinesh,Tinguely Pascale,Haddad Fares,Dodd Miranda,Dann Chris,Walker David,Pollok Joerg-Matthias,Banerjee Abhirup,Mohamed Ahmed,Obalogun Aleem,Ramirez Alejandro,Rothnie Alex,Grajn Andrej,Chikkala Bhargava,Ojo-Williams Bose,Hidalgo-Salinas Camilla,Ceresa Carlo,Frola Carlo,Tsakiris Charalampos,Shaw Conrad,Chasiotis Dimitrios,Kontis Elissaios,Froghi Farid,Venkatakrishnan Guhan,Tzerbinis Helen,Kostakis Ioannis D.,Whitehead James,Costa Joao,Patel Krishnakumure,Kathirvel Manikandan,Sharma Mitesh,Elnagar Mohamed,Somasundaram Murali,Dimitrokallis Nikolaos,Morare Nolitha,Kupfuwa Nyasharenee,Bulathsinhala Sandun,Makhdoom Shahroo,Pericleous Stephanos,Kunnuru Supreeth,Ramos-Vazquez Susana,Ibraheem Tameem,Keating Gemma,Lightfoot Linda,Brown Sophie,Gyamfi Lucy,Modi Kajal,Tufuo Vanessa,Walker Harriet Louise,

Abstract

AbstractTo mitigate COVID-19-related shortage of treatment capacity, the hepatopancreatobiliary (HPB) unit of the Royal Free Hospital London (RFHL) transferred its practice to independent hospitals in Central London through the North Central London Cancer Alliance. The aim of this study was to critically assess this strategy and evaluate perioperative outcomes. Prospectively collected data were reviewed on all patients who were treated under the RFHL HPB unit in six hospitals between November 2020 and October 2021. A total of 1541 patients were included, as follows: 1246 (81%) at the RFHL, 41 (3%) at the Chase Farm Hospital, 23 (2%) at the Whittington Hospital, 207 (13%) at the Princess Grace Hospital, 12 (1%) at the Wellington Hospital and 12 (1%) at the Lister Hospital, Chelsea. Across all institutions, overall complication rate were 40%, major complication (Clavien–Dindo grade ≥ 3a) rate were 11% and mortality rates were 1.4%, respectively. In COVID-19-positive patients (n = 28), compared with negative patients, complication rate and mortality rates were increased tenfold. Outsourcing HPB patients, including their specialist care, to surrounding institutions was safe and ensured ongoing treatment with comparable outcomes among the institutions during the COVID-19 pandemic. Due to the lack of direct comparison with a non-pandemic cohort, these results can strictly only be applied within a pandemic setting.

Publisher

Springer Science and Business Media LLC

Subject

Multidisciplinary

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