Endoscopy can be delivered safely during the COVID-19 pandemic

High-quality therapeutic ERCP, EUS, luminal stenting, and dilatation, can be delivered safely to appropriately prioritized patients during the COVID-19 pandemic.

High-quality therapeutic endoscopy service can be delivered safely to appropriately prioritized patients during the COVID-19 pandemic1. 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 post-pandemic. The British Society of Gastroenterology (BSG) has provided guidance for managing endoscopy services throughout this period.

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 have been 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.

No swabs were COVID-19-positive post-procedure. Overall, common bile duct (CBD) cannulation was achieved in 90.4% of procedures and 82.2% of ERCP procedures were 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 of 88.6%). A total of 91% had a successful stent insertion in biliary stricture disease.

Of 91 EUS procedures, 63 were diagnostic and 28 EUS biopsy (diagnostic yield 89%). Nine patients underwent successful esophageal 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 to appropriately prioritized 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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