Published online Oct 6, 2021. doi: 10.12998/wjcc.v9.i28.8404
Peer-review started: June 22, 2021
First decision: July 16, 2021
Revised: July 22, 2021
Accepted: August 30, 2021
Article in press: August 30, 2021
Published online: October 6, 2021
The coronavirus disease 2019 (COVID-19) outbreak has markedly influenced endoscopic patterns. Endoscopic retrograde cholangiopancreatography (ERCP) is an essential technique for pancreatobiliary disease but increases the risk of exposure to virus-containing body fluid; however, the impact of COVID-19 on ERCP is unknown.
Unlike upper endoscopy and colonoscopy, pancreatobiliary disorders such as bile duct obstruction or associated cholangitis usually require urgent treatment. However, endoscopy can cause human-to-human viral transmission by producing massive aerosol droplets throughout the procedure, particularly during therapeutic interventions such as ERCP. Due to the lack of experience and the highly contagious features of COVID-19, all measures to stop the viral spread in and outside the hospital were prioritized.
This study aimed to compare and to analyze the change in the number of ERCP procedures, causes, and clinical outcomes of emergency ERCP between pre-COVID-19 and during the COVID-19 outbreak in Daegu city, the worst-hit area in South Korea.
This retrospective cohort study included patients aged ≥ 18 years who underwent ERCP between February 18 and March 28, 2020, at a tertiary hospital. Baseline demographics, causes of an ER visit, blood chemistry, ERCP indications, and endoscopic details relevant to ERCP were collected and compared with those from the same period in 2018 and 2019 as control groups.
The number of ERCP procedures in 2018 and 2019 decreased by 20.2% and 56.6%, respectively, compared with that in 2020 (P < 0.01); among the 113 emergency ERCPs, the observed numbers in 2018 (n = 42) and 2019 (n = 55) dramatically dropped by 61.9% and 70.9%, respectively, compared with that in 2020 (n = 16). No case of ERCP-related infection has been reported in medical providers or other patients.
The COVID-19 outbreak significantly reduced the number of ERCPs; however, no difference was observed in the indications and endoscopic interventions before and during the COVID-19 outbreak.
All emergency ERCP procedures were performed safely without causing any viral infection in our endoscopy center. However, a long-term follow-up is warranted to observe the clinical outcomes of ERCP procedures after the cessation of the COVID-19 outbreak.