Abstract
On April 8, 2020, after nearly 3 months of battling against the outbreak of COVID-19, Wuhan, where the pandemic began, began easing lockdown restrictions. However, given that asymptomatic carriers could continue to lead to transmission of COVID-19 during the very early stages, the endoscopists have taken precautions and conduct risk assessments to perform endoscopic intervention in this transition stage. Here, we have reported an urgent ERCP in a patient with acute pancreatitis secondary to JPDD-related biliary stone. Based on our experiences, the objective is to provide practical suggestions for the safe resumption of ERCP procedures in the setting of the COVID-19 pandemic with specific focus on patient risk assessment, personal protection equipment (PPE), and dress code modalities, all of which have been implemented in our hospital to reduce the risk of viral transmission.
Highlights
The new strain of coronavirus, SARS-CoV-2, was first extracted in December 2019 from the lower respiratory tract samples of several pneumonia patients in our city, Wuhan, Hubei province, China [1,2,3]
Duodenal diverticula are bulging pouch-like herniations in the duodenal wall, and those located near the major duodenal papilla are termed juxtapapillary duodenal diverticula (JPDD)
Preforming endoscopic retrograde cholangiopancreatography (ERCP) and endoscopic sphincterotomy are widely accepted as the first-line therapy to remove bile duct stones and explicitly benefit those with the etiology of acute pancreatitis, and urgent ERCP within 72 h is required to reduce the risk of developing acute pancreatitis-associated complications [11,12,13,14]
Summary
The new strain of coronavirus, SARS-CoV-2, was first extracted in December 2019 from the lower respiratory tract samples of several pneumonia patients in our city, Wuhan, Hubei province, China [1,2,3]. She has no pre-existing conditions or major past medical history Before admission, she went through the mandatory prescreening assessment (Figure 1), which has been implemented at our hospital through the COVID-19 outbreak, including inquiry of potential contact history (whether contacted with a suspected or laboratory-confirmed COVID-19 patient in the last 2 weeks); patient’s symptom check (body temperature ≥37.3◦C, coughing or shortness of breath and/or other symptoms of acute respiratory symptom are highly suspected); laboratory test (a nasopharyngeal swab specimen for COVID-19 RNA test and serological tests for COVID-19 antibody) [6]; and a chest computed tomography (CT) scan (a typical “ground glass opacity” image is highly suspected), respectively. There was no retaining stone detected in CBD by CT scan, and no evidence of post-ERCP pancreatitis or other ERCP-related complications developed during the follow-up
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