Urgent Elective Laparoscopic Cholecystectomy during the COVID-19 Pandemic

Aim: In April 2020 routine elective surgery in England was suspended in response to coronavirus disease-2019 (COVID-19). Low COVID-19 infection and mortality rates in the South West of England allowed urgent elective surgery in Plymouth to continue with the necessary precautions. The aim of this study was to assess outcomes following elective laparoscopic cholecystectomy during the initial phase of the COVID-19 pandemic. Materials and methods: Records of 54 consecutive patients undergoing urgent elective laparoscopic cholecystectomy between March 25, 2020, and June 25, 2020, were analyzed retrospectively. Patients were telephoned after 30 days. All patients underwent COVID-19 swab testing 24 to 72 hours prior to surgery and during admission if clinically indicated. The primary outcome measure was COVID-19 related morbidity. Secondary outcome measures were non-COVID-19 related morbidity, mortality, and length of hospital stay. Results: Fifty-four patients [19 male, 35 female; median age 59 years (20–79); median body mass index (BMI) 31 kg/m² (22.9–46.8); median ASA 2] underwent laparoscopic cholecystectomy during the study period. Fifty-one patients (94%) were of White-British ethnicity. One patient tested positive for COVID-19 preoperatively. There were no COVID-19 diagnoses postoperatively and no COVID-19 related morbidity. There were no deaths at 30 days. Forty-four patients (81%) had a day-case procedure. Forty-two (78%) procedures were performed by a supervised trainee. Conclusion: Elective laparoscopic cholecystectomy can be performed safely and training maintained in areas of low COVID-19 prevalence with the necessary precautions. Clinical significance: This small study provides some evidence to aid decision-making around the provision of elective surgical services during this ongoing pandemic.