What has changed? The impact of the COVID-19 pandemic on the management of acute biliary pancreatitis

BACKGROUND: The COVID-19 pandemic thoroughly changed the daily practices of medicine. We retrospectively evaluated the impact of the COVID-19 pandemic on our management strategies for patients with acute biliary pancreatitis (ABP). METHODS: A total of 91 patients with ABP who were treated at Trakya University Faculty of Medicine between March 15, 2019 and March 15, 2021 were retrospectively recruited. Patients were classified as pre-COVID and COVID-era patients. The comorbidity markers, data from laboratory tests, inflammatory markers, and radiological examinations were evaluated. Length of stay, need for an intensive care unit, morbidity, mortality, recurrent ABP, and definitive treatment rates were evaluated, and the data of the two periods were compared. RESULTS: Two groups of patients, 57 in the pre-COVID period and 34 in the COVID period, were included in the study. We found that ABP admissions decreased significantly during periods of increased national COVID-19 diagnoses. Type 2 diabetes mellitus was significantly higher in the COVID period patients (P=0.044), and COVID patients had significantly higher total (P=0.004), direct bilirubin (P=0.007), and lipases (P<0.001). The cholecystectomy rate after an attack decreased from 26% in the pre-COVID period to 15.6% during COVID. CONCLUSION: COVID strikingly reduced the admissions of ABP patients in the early stages of the disease to hospitals, leading to inevitable admissions in advanced severity. Moreover, a significant increase was detected in the recurrence rates of ABP. This can be explained by the reduction in cholecystectomy performed.