IMPACT OF THE COVID-19 PANDEMIC ON THE CLINICAL PROFILE AND SURGICAL MANAGEMENT OF ACUTE CHOLECYSTITIS: A RETROSPECTIVE REVIEW

Catalin Cosma; El-Cheikh Taha Abdul-Kader; Calin Molnar; Tudor Negruti; Ahmed Sohaib; Ioana Cosma-Epure; Dragos Molnar

doi:10.33695/rojes.v6i1.97

Catalin Cosma SCJU Tg.Mures Chirurgie 1
El-Cheikh Taha Abdul-Kader UMFST Tg.Mures
Calin Molnar SCJU Tg.Mures Chirurgie 1
Tudor Negruti SCJU Tg.Mures Chirurgie 1
Ahmed Sohaib SCJU Tg.Mures Chirurgie 1
Ioana Cosma-Epure UMFST Tg.Mures
Dragos Molnar SCJU Tg.Mures Chirurgie 1

DOI: https://doi.org/10.33695/rojes.v6i1.97

Keywords: ACUTE CHOLECYSTITIS, COVID-19, PANDEMIC, LAPAROSCOPIC CHOLECYSTECTOMY, EMERGENCY SURGERY

Abstract

Introduction: Acute cholecystitis (AC) is a common surgical emergency, often requiring urgent laparoscopic intervention. The COVID-19 pandemic disrupted healthcare systems globally, potentially altering patient presentation, disease severity, and management pathways. This study aims to compare the clinical characteristics and surgical outcomes of AC in the pre-pandemic and post-pandemic periods.
Material & Method: We conducted a retrospective observational study at the General Surgery 1 Department of SCJU Târgu Mureș, including 434 patients diagnosed with AC between January 2018 and January 2024. Patients were stratified into two groups: pre-COVID (2018–11 March 2020) and post-COVID (12 March 2020–2024). Data included demographic characteristics, laboratory and imaging findings, surgical approach, complications, and mortality. Statistical analyses included Mann-Whitney U, Chi-square/Fisher’s exact tests, Spearman correlation, and binary logistic regression.
Results: Of the 434 patients, 136 were treated pre-pandemic and 298 post-pandemic. The mean age was comparable (56.5 vs. 58.3 years). Laparoscopic cholecystectomy remained the dominant approach (>90%) across both groups. The rate of gallbladder perforation decreased post-COVID (18.6% vs. 11.6%, p = 0.08). No significant differences were found in WBC, neutrophil count, or mortality (2.9% vs. 1%). Conversion to open surgery increased post-pandemic (from 0.7% to 4.1%), but without statistical significance. Multivariate analysis revealed that the pre-pandemic period was independently associated with a higher risk of gallbladder perforation (OR = 2.13, p = 0.018).
Conclusion: Despite the systemic strain imposed by the COVID-19 pandemic, surgical management of acute cholecystitis remained effective and safe in our center. The decline in perforation and low mortality post-COVID suggests improved triage and perioperative protocols during the pandemic aftermath. Continuous adaptation in emergency surgical care is vital for resilience in future healthcare crises.

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