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. 2020 Jul;20(4):352–358. doi: 10.7861/clinmed.2020-0296

Table 1.

Emergency and essential endoscopies continued during peak phase of COVID-19

Procedure Indication
Upper GI endoscopy Acute upper-GI bleeding (including ongoing banding of varices post-acute bleed)
Total dysphagia and food bolus obstruction
Obstructing upper-GI lesion requiring stenting or therapy
Urgent nutritional support with nasogastric/jejunal tube or percutaneous endoscopic gastrostomy (PEG)
Endoscopic vacuum therapy
Endoscopic retrograde cholangiopancreatography (ERCP) and hepatico-pancreatico-biliary endoscopic ultrasound (EUS) All presentations of cholangitis
Obstructive jaundice, where required for significant symptoms or preoperatively
Biliary stent change if clinically indicated (asymptomatic plastic stents deferred for max 3 months, asymptomatic fully covered metallic stents deferred for max 1 year)
Post-operative complications – bile leak, stricture
Pancreatic stent for disrupted duct
Therapeutic EUS – drainage of peripancreatic collections and biliary drainage after failed ERCP
Capsule endoscopy (small bowel) Continuous or frequent small-bowel bleeding (overt or occult) in patients who are hospital-dependent or requiring repeated hospital admissions
Device-assisted enteroscopy (small bowel) For therapy, for example continuous or frequent small bowel bleeding (overt or occult) in patients who are hospital-dependent or requiring repeated hospital admissions
Lower GI endoscopy (colonoscopy or flexible sigmoidoscopy) Ongoing lower GI bleeding where interventional radiology is not possible or unsuccessful