FTP7.8 Has Endoscopic retrograde cholangiopancreatography (ERCP) management of acute biliary obstruction due to gallstones been affected during the Covid-19 pandemic? – A single unit experience

Abstract

Abstract Introduction British Society of Gastroenterology (BSG) guidelines advised for ERCP procedures to be continued for emergency biliary pathologies during the Covid pandemic. We aim to compare the performance and outcomes of ERCP for acute gallstone biliary obstruction before, during, and post first and second covid waves at our unit. Methods Retrospective study of all patients with acute biliary obstruction secondary to gallstones who underwent ERCP from January to December 2020 (covid), compared with those between January to December 2019 (pre-covid), and between January to December 2021 (post-covid). Results 65 patients underwent ERCP for obstructed gallstones in the covid group, compared to 64 in pre-covid and 64 in post-covid group. Higher proportion of patients presented with severe jaundice (bilirubin >100) in the covid group, compared to pre-covid (P=0.031) and post-covid (P=0.028) groups. Proportion of patients with biliary sepsis requiring antibiotics was higher in covid group compared to pre-covid (P=0.031) and post-covid groups (P=0.047). The median waiting time for ERCP was 3 days in covid group, 4 days in pre-covid, and 5 days in post-covid. Compared to both pre-covid and post-covid groups respectively, there was no statistically significant reduction in the covid group in any of: proportion of complete CBD clearance (P=0.26 P=0.40), sphincterotomies performed (P=0.22, P=0.49), or successful CBD stent insertion (P=085. P=0.52). There was no statistical difference in post-ERCP complication rates comparing Covid with pre-covid (P=0.47), or post-covid (P=0.24) groups. Conclusions Quality of ERCP management of acute gallstone biliary obstruction has been maintained throughout the covid pandemic at our unit.