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Multidisciplinary management of acute cholecystitis during the COVID-19 pandemic

I Tóth1, S Ábrahám1, Z Karamya2

  • 1Department of Surgery, University of Szeged, Szeged, Hungary.

Scientific Reports
|September 27, 2023
PubMed

Insights

The COVID-19 pandemic lockdown saw a 72.8% rise in acute cholecystitis (AC) admissions. Gallbladder perforation and readmissions increased, with younger patients and more frequent percutaneous transhepatic gallbladder drainage (PTGBD).

Area of Science:

  • Gastroenterology and Hepatology
  • Surgical Outcomes
  • Epidemiology

Background:

  • The COVID-19 pandemic significantly disrupted healthcare services globally.
  • Acute cholecystitis (AC) management may have been affected by public health measures like lockdowns.
  • Assessing AC outcomes during the pandemic is crucial for understanding healthcare system impacts.

Purpose of the Study:

  • To evaluate the clinical outcomes of acute cholecystitis during the COVID-19 pandemic's nationwide lockdown.
  • To compare patient demographics, AC severity, treatment strategies, and outcomes between the lockdown period and a pre-pandemic historical control period.

Main Methods:

  • A comparative study analyzing patients admitted for AC.
  • Data collected included patient characteristics, Charlson Comorbidity Index (CCI), AC severity, treatment modality, and outcomes.
  • Comparison between a lockdown period (April 2020-November 2021) and a historical control period (May 2017-December 2018).

Main Results:

  • AC admissions increased by 72.8% during the lockdown period.
  • Patients during lockdown were younger and had a higher prevalence in the CCI 1 group.
  • Higher rates of gallbladder perforation (GP) and unplanned readmissions were observed during lockdown, alongside increased use of percutaneous transhepatic gallbladder drainage (PTGBD).

Conclusions:

  • The nationwide COVID-19 lockdown was associated with a significant increase in acute cholecystitis prevalence.
  • Gallbladder perforation and unplanned readmissions were more frequent during the lockdown period.
  • Treatment trends shifted towards more invasive procedures like PTGBD, with less frequent successful conservative management.

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