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Original research
Impact of COVID-19 pandemic on key performance indicators in pancreatobiliary endoscopy: prioritise, minimise risk, keep scoping and training
  1. Shiran Esmaily,
  2. Chia Chuin Yau,
  3. Deepak Dwarakanath,
  4. John Hancock,
  5. Vikramjit Mitra
  1. Gastroenterology, University Hospital of North Tees, Stockton-on-Tees, UK
  1. Correspondence to Dr Vikramjit Mitra, Gastroenterology, University Hospital of North Tees, Stockton-on-Tees TS19 8PE, UK; vmitra{at}nhs.net

Abstract

Background The COVID-19 pandemic has profoundly affected endoscopy services including pancreatobiliary (PB) endoscopy across the UK. The British Society of Gastroenterology and Joint Advisory Group have issued guidance for managing endoscopy services safely throughout this period. There have been perceived concerns among the PB endoscopists that wearing full personal protective equipment might have an adverse impact on key performance indicators (KPIs) in endoscopic retrograde cholangiopancreatography (ERCP) and endoscopic ultrasound (EUS) procedures leading to non-compliance with the national guidelines. The aim of the study was to assess the impact of COVID-19 pandemic on KPIs in ERCP and EUS and ascertain the risk of procedure-related complications.

Methods A retrospective audit of a prospectively maintained endoscopy database was carried out between 18 March and 31 July 2020.

Results 146 ERCP procedures (common bile duct (CBD) cannulation rate of naïve papilla 89.2%, complete CBD stone extraction rate at first ERCP 88.2%, biliary stricture decompression rate 91%) and 87 EUS procedures (diagnostic accuracy of EUS-fine needle aspiration 92%) were carried out during this period. ERCP-related complications included pancreatitis (4.8%), bleeding (0.68%) and cholangitis (0.68%). 30-day ERCP procedure-related mortality was 0.68%. There were no complications or procedure-related mortality in the EUS group.

Conclusion This is the first study looking at the impact of COVID-19 on KPIs and procedure-related complications in ERCP and EUS in the literature. Our study confirms that a high-quality PB endoscopy service can be delivered safely and effectively during the COVID-19 pandemic.

  • endoscopic retrograde pancreatography
  • endoscopic ultrasonography
  • pancreato-biliary disorders

Data availability statement

All data relevant to the study are included in the article or uploaded as supplementary information. We agree to the data policy and are happy for you to publish in the journal if deemed suitable for publication.

This article is made freely available for use in accordance with BMJ’s website terms and conditions for the duration of the covid-19 pandemic or until otherwise determined by BMJ. You may use, download and print the article for any lawful, non-commercial purpose (including text and data mining) provided that all copyright notices and trade marks are retained.

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Data availability statement

All data relevant to the study are included in the article or uploaded as supplementary information. We agree to the data policy and are happy for you to publish in the journal if deemed suitable for publication.

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Footnotes

  • Correction notice This article has been corrected since it published Online First. The formatting of the title has been corrected.

  • Contributors SE performed the data collection, analysed the data and contributed to writing of the manuscript. CCY performed the data collection. DD and JH contributed to writing of the manuscript. VM oversaw the data collection, analysis and interpretation, and contributed to write-up.

  • Funding The authors have not declared a specific grant for this research from any funding agency in the public, commercial or not-for-profit sectors.

  • Competing interests None declared.

  • Provenance and peer review Not commissioned; externally peer reviewed.