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Endoscopy can be delivered safely during the COVID-19 pandemic

Presented by
S. Esmaily, University Hospital North Tees, UK
UEGW 2020
High-quality therapeutic endoscopy services can be delivered safely in appropriately prioritised patients during the COVID-19 pandemic [1]. The authors presented their experiences with ERCP, EUS, luminal stenting, and dilatation during this period.

In the UK, the COVID-19 pandemic began in mid-March 2020 and peaked by late April. In the following months, the UK was in an early recovery phase of restarting endoscopy after the first wave of COVID-19. The British Society of Gastroenterology has provided guidance for managing endoscopy services in this period.

The current study aimed to assess the number of COVID-19-positive swabs in the 28 days following a procedure. At the beginning of the pandemic, patients were screened for COVID-19 prior to their endoscopic procedures using a symptom-based questionnaire. From 18 May 2020 onwards, all patients attending therapeutic endoscopic procedures underwent a SARS-CoV-2 nasopharyngeal swab 1-3 days prior to the procedure, in addition to a screening questionnaire for COVID-19 symptoms.

All therapeutic procedures from 18 March –when the pandemic emerged in the UK– until 31 July were included and all patients were followed up for 30 days post procedure. Between 18 March and 17 May, 110 therapeutic procedures were performed, and between 18 May and 31 July 169 procedures were performed.

No swabs were COVID-19-positive in the 28 days after the procedure. Overall, common bile duct (CBD) cannulation was achieved in 90.4% of procedures and 82.2% of ERCP procedures was done on a naïve papilla. CBD cannulation in naïve papilla was 89.2%. Of all ERCP procedures, 47.9% was performed for stone disease (duct clearance rate 88.6%). A total of 91% had a successful stent insertion in biliary stricture disease. Of 91 EUS procedures, 63 were diagnostic and 28 biopsy (diagnostic yield 89%). Nine patients underwent successful oesophageal stenting and 33 patients underwent successful oesophageal dilatation (both 100% technical and clinical success). One patient underwent successful colonic decompression. Procedure-related mortality was 0.7% (2 patients).

This study confirms that in appropriately prioritised patients high-quality therapeutic endoscopy service can be delivered safely during the COVID-19 pandemic.

  1. Esmaily S. ERCP, EUS, luminal stenting and dilatation: experience from a university teaching hospital in the United Kingdom during the covid 19 pandemic. UEG Week Virtual 2020, abstract LB03.

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