How did the general surgeons intend to treat acute calculous cholecystitis during COVID-19 era?Results of online survey

BACKGROUND: Acute calculous cholecystitis is one of the most encountered surgical pathologies. While early cholecystectomy is the first treatment choice during the first index hospitalization, it may change during COVID-19 era when hospital resources are re-stricted, and health-care personnel try to overcome pandemic difficulties. In this survey, our aim is to investigate surgeons’ preferences and possible changing paradigms for acute cholecystitis therapy during COVID-19 pandemic.
METHODS: An online survey was conducted on an internet site through private invitation by social media sent to general surgeons. The survey consisted of 13 questions, including surgeons’ hospital properties, and it questioned treatment preferences against acute calculous cholecystitis during the pandemic. After 3 months of data collection, responded answers were analyzed statistically.
RESULTS: About 56% of the surgeons stated that their treatment strategy changed during the COVID-19 pandemic partially or totally. About 48.8% of surgeons preferred early cholecystectomy for cases with acute cholecystitis before COVID-19 era; when only 23.2% of the surgeons preferred early surgery during COVID-19 era. However, patients who had received antibiotics as primary medical therapy had medical therapy failure with a range of 40.2%. Percutaneous cholecystostomy rate was raised to 20.7% from 4.9% before the COVID era.
CONCLUSION: Although 96.3% of the surgeons did not have seen any unusual complication related to the COVID-19 disease, more than half of the surgeons who preferred early cholecystectomy changed their treatment strategy during the COVID-19 pandemic. According to the survey results, although the medical therapy failure rate is high, 48.8% of the surgeons may persist in this non-operative approach after the pandemic.

Genel cerrahlar akut taþlý kolesistiti COVID-19 döneminde nasýl tedavi ettiler? Online anket sonuçlarý

AMAÇ: Akut taþlý kolesistit en sýk karþýlaþýlan cerrahi patolojilerden biridir. Akut taþlý kolesistit tanýsýyla ilk yatýþ sýrasýnda erken kolesistektomi ilk tedavi seçeneði iken, hastane kaynaklarýnýn kýsýtlý olduðu ve saðlýk personelinin pandemi zorluklarýnýn üstesinden gelmeye çalýþtýðý COVID-19 döne-minde yaklaþým deðiþebilir. Bu ankette amacýmýz, COVID-19 pandemisi sýrasýnda akut taþlý kolesistit tedavisi için genel cerrahlarýn tercihlerini ve olasý deðiþen paradigmayý araþtýrmaktýr.
GEREÇ VE YÖNTEM: Cerrahlara özel kapalý bir sosyal medya grubunda paylaþýlan anket linki üzerinden online anket yapýlmýþtýr. Genel cerrahlarýn mesleki deneyimi, çalýþtýklarý kurum özellikleri ile birlikte COVID-19 dönemindeki akut taþlý kolesistit hastalýðýna yönelik tedavi tutumlarý 13 soruluk anket aracýlýðýyla çoktan seçmeli sorularla sorgulandý. Üç aylýk veri toplama dönemi sonrasý elde edilen cevaplar istatistiksel olarak analiz edildi. BULGULAR: Çalýþmaya katýlan 82 genel cerrahýn %56’sý COVID-19 pandemisi sýrasýnda tedavi stratejilerinin kýsmen veya tamamen deðiþtiðini ifade etmiþtir. Cerrahlarýn %48.8’i COVID-19 döneminden önce akut taþlý kolesistitli olgularda erken kolesistektomiyi tercih ederken; COVID-19 döneminde cerrahlarýn sadece %23.2’si erken cerrahi yaklaþýmý tercih ettiklerini ifade ettiler. Ancak birincil týbbi tedavi olarak antibiyotik baþlanan hastalarda týbbi tedavi baþarýsýzlýðý %40.2 olarak tespit edildi. Anket sonuçlarýmýza göre perkütan kolesistostomi uygulamasý COVID öncesi dönemde %4.9 iken, pandemi döneminde %20.7’ye yükseltilmiþtir.
TARTIÞMA: Cerrahlarýn %96.3’ü COVID-19 hastalýðýna baðlý bir komplikasyon görmemesine raðmen; COVID-19 pandemisi öncesi erken kolesis-tektomiyi tercih eden cerrahlarýn yarýsýndan fazlasý COVID-19 pandemisi sýrasýnda tedavi stratejilerini deðiþtirmiþtir. Anket sonuçlarýna göre týbbi tedavi baþarýsýzlýk oraný yüksek olmasýna raðmen, cerrahlarýn %48.8’i pandemi sonrasýnda da bu non-operatif yaklaþýma devam edebileceklerini ifade etmiþtir.