JMIR Publications

ABSTRACT

Background:

The hepato-pancreato-biliary (HPB) unit had to scale down the clinical workload and reallocate resources to combat COVID-19.

Objective:

We report local audit evaluating the impact of COVID-19 on the unit and its impact on cancer surgery.

Methods:

We performed a comparative audit of the HPB team surgical workload for January-June 2019 (baseline) and 2020 (COVID-19). Elective and emergency cases performed under general anesthesia were audited. Elective cases included hernia surgeries, biliary surgeries (cholecystectomy and complex biliary resections), liver, and pancreatic resections. Emergency cases included cholecystectomies and laparotomies performed for general surgical indications. We excluded endoscopy and procedures done under local anaesthesia.

Results:

Elective surgical workload decreased by 42.3% during the COVID-19 pandemic (n=200 (2019) vs. 347 (2020)). Hernia surgery decreased by 63.9% (n=155 (2019) vs. 56 (2020)) and cholecystectomy by 40.3% (n=144 (2019) vs. 86 (2020)). Liver and pancreatic resection volume increased by 16.7% (n=30 (2019) vs. 35 (2020)) and 111.1% (n=9 (J 2019) vs. 19 (2020)). The emergency surgical workload reduced by 40.9% (n=193 (2019) vs. 114 (2020)).

Conclusions:

Reallocation of resources due to the COVID-19 pandemic did not adversely impact elective HPB oncology work. With prudent measures in place, essential surgical services can be maintained during a pandemic.