Ulus Travma Acil Cerrahi Derg. 2023; 29(10): 1167-1174 | DOI: 10.14744/tjtes.2023.06486

What has changed? The impact of the COVID-19 pandemic on the management of acute biliary pancreatitis

Zeliha Türkyýlmaz, Tugrul Demirel, Ýbrahim Ethem Cakcak, Yusuf Emre Aytin
Department of General Surgery, Trakya University, Edirne-Türkiye

BACKGROUND: The COVID-19 pandemic thoroughly changed the daily practices of medicine. We retrospectively evaluated the impact of the COVID-19 pandemic on our management strategies for patients with acute biliary pancreatitis (ABP).
METHODS: A total of 91 patients with ABP who were treated at Trakya University Faculty of Medicine between March 15, 2019 and March 15, 2021 were retrospectively recruited. Patients were classified as pre-COVID and COVID-era patients. The comorbidity markers, data from laboratory tests, inflammatory markers, and radiological examinations were evaluated. Length of stay, need for an intensive care unit, morbidity, mortality, recurrent ABP, and definitive treatment rates were evaluated, and the data of the two periods were compared.
RESULTS: Two groups of patients, 57 in the pre-COVID period and 34 in the COVID period, were included in the study. We found that ABP admissions decreased significantly during periods of increased national COVID-19 diagnoses. Type 2 diabetes mellitus was significantly higher in the COVID period patients (P=0.044), and COVID patients had significantly higher total (P=0.004), direct bili-rubin (P=0.007), and lipases (P<0.001). The cholecystectomy rate after an attack decreased from 26% in the pre-COVID period to 15.6% during COVID.
CONCLUSION: COVID strikingly reduced the admissions of ABP patients in the early stages of the disease to hospitals, leading to inevitable admissions in advanced severity. Moreover, a significant increase was detected in the recurrence rates of ABP. This can be explained by the reduction in cholecystectomy performed.

Keywords: Acute biliary pancreatitis, cholecystectomy; COVID era; COVID-19; systemic inflammatory response index.

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Ne deðiþti? COVID-19 pandemisinin akut biliyer pankreatit tedavisine etkisi

Zeliha Türkyýlmaz, Tugrul Demirel, Ýbrahim Ethem Cakcak, Yusuf Emre Aytin
Trakya Üniversitesi Týp Fakültesi, Genel Cerrahi Ana Bilim Dalý, Edirne, Türkiye

AMAÇ: COVID-19 Pandemisi, týptaki günlük uygulamalarý kökten deðiþtirdi. COVID-19 Pandemisinin, akut biliyer pankreatitli (ABP) hastalarda yönetim stratejilerimiz üzerindeki etkisini retrospektif olarak deðerlendirmeyi amaçladýk.
GEREÇ VE YÖNTEM: Trakya Üniversitesi Týp Fakültesi'nde 15 Mart 2019-15 Mart 2021 tarihleri arasýnda tedavi edilen ABP'li toplam 91 hasta geriye dönük olarak incelendi. Hastalar COVID öncesi ve COVID dönemi hastalarý olarak sýnýflandýrýldý. Komorbidite belirteçleri, laboratuvar test-lerinden elde edilen veriler, inflamatuar belirteçler ve radyolojik incelemeler deðerlendirildi. Hastanede yatýþ süresi, yoðun bakým ihtiyacý, morbidite, mortalite, tekrarlayan ABP ve kesin tedavi oranlarý deðerlendirildi ve iki döneme ait veriler karþýlaþtýrýldý.
BULGULAR: Çalýþmaya COVID öncesi dönemde 57 ve COVID döneminde 34 olmak üzere iki hasta grubu dahil edildi. Ulusal yeni COVID-19 tanýlarý arttýðý dönemlerde ABP baþvurularýnýn önemli ölçüde azaldýðýný saptadýk. Tip 2 Diyabet (T2DM) COVID dönemindeki hastalarda anlamlý olarak yüksekti (p=0.044) ve COVID hastalarýnda anlamlý olarak daha yüksek total (p=0.004), direkt bilirubin (p=0.007) ve lipaz deðerleri (p<0.001) vardý. Atak sonrasý kolesistektomi oraný, COVID öncesi dönemde %26'dan COVID sýrasýnda %15,6'ya düþtü.
SONUÇ: COVID-19 pandemisi, ABP hastalarýnýn erken evrede hastanelere baþvurularýný çarpýcý bir þekilde azalttý ve kaçýnýlmaz þekilde geç baþvurulara yol açtý. Ayrýca ABP'nin tekrarlama oranlarýnda anlamlý bir artýþ tespit edildi. Bu durum atak sonrasý kolesistektomi oranlarýndaki azalma ile açýklanabilir.

Anahtar Kelimeler: Akut biliyer pankreatit, COVID-19; COVID dönemi; SIRI; kolesistektomi.

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