How did the general surgeons intend to treat acute calculous cholecystitis during COVID-19 era?Results of online survey.

Background: Acute calculous cholecystitis is one of the most encountered surgical pathologies. While early cholecystectomy is the first treatment choice during the first index hospitalization, it may change during COVID-19 era when hospital resources are restricted, and health-care personnel try to overcome pandemic difficulties. In this survey, our aim is to investigate surgeons' preferences and possible changing paradigms for acute cholecystitis therapy during COVID-19 pandemic.

Methods: An online survey was conducted on an internet site through private invitation by social media sent to general surgeons. The survey consisted of 13 questions, including surgeons' hospital properties, and it questioned treatment preferences against acute calculous cholecystitis during the pandemic. After 3 months of data collection, responded answers were analyzed statistically.

Results: About 56% of the surgeons stated that their treatment strategy changed during the COVID-19 pandemic partially or totally. About 48.8% of surgeons preferred early cholecystectomy for cases with acute cholecystitis before COVID-19 era; when only 23.2% of the surgeons preferred early surgery during COVID-19 era. However, patients who had received antibiotics as primary medical therapy had medical therapy failure with a range of 40.2%. Percutaneous cholecystostomy rate was raised to 20.7% from 4.9% before the COVID era.

Conclusion: Although 96.3% of the surgeons did not have seen any unusual complication related to the COVID-19 disease, more than half of the surgeons who preferred early cholecystectomy changed their treatment strategy during the COVID-19 pandemic. According to the survey results, although the medical therapy failure rate is high, 48.8% of the surgeons may persist in this non-operative approach after the pandemic.