Reduction in ERCP volume for Acute Cholangitis and other Indications during COVID-19 Pandemic

Abstract

Introduction: The COVID-19 pandemic continues to significantly impact healthcare with Joint Gastrointestinal Societies recommending rescheduling elective and non-urgent endoscopic procedures. The aim of our study was to evaluate the trend of acute cholangitis requiring emergent ERCP and overall ERCP practice in the setting of the COVID 19 pandemic. Methods: A retrospective review of all ERCPs performed at our institution was performed during the study period (3/16/2020 to 4/15/2020) along with the preceding 2 months (1/1/2020 to 2/29/2020) and similar time period from the last 2 years (3/16/2019 to 4/15/2019 and 3/16/2018 to 4/15/2018) for comparison to account for any seasonal variation. Results: A reduction was noted in absolute number and proportion of ERCPs performed for acute cholangitis during the study period compared to preceding months (2 [6.45%] vs. average 10.5 [15.05%] cases/month; 81% reduction). We also found reduction in overall number of both inpatient and outpatient ERCPs during the study period (31 ERCPs/month to average 70 ERCPs/month; 55% reduction in ERCP volume). Conclusions: There was a reduction in the overall ERCP volume and number of ERCPs performed for acute cholangitis during the COVID-19 pandemic. Further larger studies are needed to validate this data and investigate its causes. Keywords: ERCP; COVID-19; SARS-2-Cov; Pandemic; Acute cholangitis; Trend; Biliary