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      <JournalTitle>International Journal of Clinical Investigation and Case Reports</JournalTitle>
      <Volume-Issue>Volume 1, Issue 2</Volume-Issue>
      <ArticleTitle>Impact of COVID-19 Restrictions on Outcomes of Patients with Cholelithiasis during the Pandemic</ArticleTitle>
          <FirstName>Constanza S.</FirstName>
          <FirstName>Franco J.</FirstName>
          <FirstName>Manque F.</FirstName>
          <FirstName>Cecilia L.</FirstName>
          <FirstName>Marcelo J.</FirstName>
          <FirstName>Marina A.</FirstName>
          <FirstName>Alberto R. Ferreres*</FirstName>
      <Abstract>Introduction: The COVID-19 pandemic restrictions forced the postponement of most elective surgeries for pathologies that did not represent an imminent risk to life. This delay caused significantly higher Re-admission and complication rates in patients with cholelithiasis during the pandemic, compared to those who presented before the pandemic (p-value=0.0001).&#13;
Objective: To evaluate the impact of delayed surgical management of symptomatic gallstones, during the Covid-19 pandemic, on the complication and re-admission rates.&#13;
Design type: a descriptive retrospective.&#13;
Method: A cohort of patients hospitalized with pancreatobiliary pathology during the pandemic was compared to a control group who presented before the pandemic. Two groups were compared for the incidence of gallstone complications and re-admission rates. Primary or secondary neoplastic pathologies associated with gallstones were excluded.&#13;
Results: During the pre-pandemic period, between March 2019 and March 2020, a total of 408 patients with pancreatobiliary pathology were hospitalized. Out of 408 patients, 204 (50%) were admitted with acute biliary cholecystitis, 132 patients with acute pancreatitis (32.4%), and 72 patients with extrahepatic cholestasis (17.6%). 324 (79%) patients underwent surgery and 36 (8.82%) patients out of the remaining 84 (20.6%) patients were readmitted. The average hospital stay for patients with surgery was 4 days ---PlusMinusSymbol--- 1.6 days, while for those with non-surgical treatment was 7 days ---PlusMinusSymbol--- 1.4 days. From March 2020 to March 2021, a total number of 536 patients were hospitalized, including 252 (47%) with acute biliary cholecystitis, 144 (26.9%) with acute pancreatitis, and 128 (23.9%) with extrahepatic cholestasis and 12 with acute cholangitis (2.2%). 308 (57.5%) patients underwent surgery and 104 (19.4%) patients of the remaining 228 (42.5%) patients were readmitted. The average hospital stay for patients with surgery was 3 days ---PlusMinusSymbol--- 1.3 days, while for those with non-surgical treatment was 7 days ---PlusMinusSymbol--- 1.5 days.&#13;
Conclusions: The comparison of both groups showed a higher incidence of gallstone complications during the pandemic, associated with the preference of medical over surgical management. The higher incidence of complications were seen and associated with a decrease in the number of scheduled laparoscopic cholecystectomies.</Abstract>
      <Keywords>COVID-19,Gallstones,Evolutionary Complications,Difficult Laparoscopic Cholecystectomy,Cholelithiasis</Keywords>
        <Abstract>https://ijcicr.com/ubijournal-v1copy/journals/abstract.php?article_id=14061&amp;title=Impact of COVID-19 Restrictions on Outcomes of Patients with Cholelithiasis during the Pandemic</Abstract>
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