Impact of the first wave of COVID-19 on the ERCP services in a single secondary endoscopy unit at the North of England: a retrospective analysis of the endoscopy database at royal lancaster infirmary

Gadour, Eyad Agu Okwudili Musharaf Mutwakil Abdalla Hassan Dixon Megan Abdalla Arabiyat Askar Amr Hafeez Siddrah Yousuf Shafiq Moradi Julia

BackgroundBritish Society of Gastroenterology (BSG) recommended that the endoscopy units to perform ERCP during the COVID-19 pandemic for obstructive biliary pathologies in an emergency. We aim to assess the local performance of ERCP during the COVID-19 first wave at our local endoscopy centre.MethodsAll ERCP procedures performed from January 2020 to Jun 2020 were retrospectively assessed and compared with procedures performed between January-Jun 2019 at Royal Lancaster Infirmary. Indications of ERCP, success rate, and complications were studied separately. Correlation analysis was conducted using Spearman’s rank correlation coefficient. The binary logistic regression model was carried out to compute factors associated with successful ERCP. The significance is established when the two-sides P-value < 0.05. Statistical analysis was performed using SPSS software version 25 for Windows (SPSS Inc., Chicago, IL, USA) (Corporation, 2017).ResultsFrom 281 patients, 60.14% and 38.14% patients were presented for ERCP procedures before and after COVID-19 period respectively. Higher proportion of patients was presented with liver dysfunction before pandemic period as compared to pandemic period (P<0.005) and use of antibiotics was significantly higher in pandemic period (P<0.05). the success rate of ERCP procedure was higher before emergence of the pandemic and lesser during the COVID-19 first wave as 86.39% and 77.67% respectively but the results were insignificant (P=0.07). A statistically significant but negative correlation was observed between cholangitis and stent insertion with ERCP success and positive correlation between sphincterotomy and ERCP success as (r=-0.129, P=0.030), (r= -0.172, P=0.004) and (r= 0.232, P<0.001) respectively. In binary logistic regression analysis, sphincterotomy (β =2.800, P=0.028) and stent insertion (β =0.852, P=0.046) were statistically significant predictors of ERCP outcomes. There was no statistically significant impact of cholangitis in the success of ERCP (β =1.672, P=0.109).ConclusionCOVID-19 pandemic significantly reduced ERCP procedures and success rate was also lowered due to restriction on endoscopic services in UK and all over the world. The endoscopic services can be resumed subject to specific SOPs to be followed in endoscopic units without affecting the safety of staff and patients.