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Restarting gastrointestinal endoscopy in the deceleration and early recovery phases of COVID-19 pandemic: Guidance from the British Society of Gastroenterology

Colin J Rees, James E East, Kofi Oppong, Andrew Veitch, Mark McAlindon, John Anderson, Bu Hayee, Cathryn Edwards, Alastair McKinlay and Ian Penman
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DOI: https://doi.org/10.7861/clinmed.2020-0296
Clin Med July 2020
Colin J Rees
ANewcastle University, Newcastle Upon Tyne, UK and consultant gastroenterologist, South Tyneside and Sunderland NHS Foundation Trust, South Shields, UK
Roles: professor of gastroenterology
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  • For correspondence: colin.rees@newcastle.ac.uk
James E East
BOxford University Hospitals NHS Foundation Trust, Oxford, UK
Roles: consultant gastroenterologist
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Kofi Oppong
CNewcastle upon Tyne Hospitals NHS Foundation Trust
Roles: consultant gastroenterologist
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Andrew Veitch
DThe Royal Wolverhampton NHS Trust, Wolverhampton, UK
Roles: consultant gastroenterologist
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Mark McAlindon
ESheffield Teaching Hospitals NHS Trust, UK
Roles: consultant gastroenterologist
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John Anderson
FGloucestershire Hospitals NHS Foundation Trust, UK
Roles: consultant gastroenterologist
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Bu Hayee
GKing's College Hospital NHS Foundation Trust, London, UK
Roles: consultant gastroenterologist
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Cathryn Edwards
HBritish Society of Gastroenterology (BSG) and consultant gastroenterologist, Torbay and South Devon NHS Foundation Trust, Torbay, UK
Roles: president
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Alastair McKinlay
IBSG and consultant gastroenterologist, Aberdeen Royal Infirmary, Aberdeen, UK
Roles: president-elect
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Ian Penman
JBSG and consultant gastroenterologist, Royal Infirmary of Edinburgh, UK
Roles: vice president endoscopy
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    Fig 1.

    Downloads of all British Society of Gastroenterology (BSG) documents (endoscopy and non-endoscopy) from BSG website between 4 April 2020 and 4 May 2020.

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    Table 1.

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

    ProcedureIndication
    Upper GI endoscopyAcute 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
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Restarting gastrointestinal endoscopy in the deceleration and early recovery phases of COVID-19 pandemic: Guidance from the British Society of Gastroenterology
Colin J Rees, James E East, Kofi Oppong, Andrew Veitch, Mark McAlindon, John Anderson, Bu Hayee, Cathryn Edwards, Alastair McKinlay, Ian Penman
Clinical Medicine Jul 2020, 20 (4) 352-358; DOI: 10.7861/clinmed.2020-0296

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Restarting gastrointestinal endoscopy in the deceleration and early recovery phases of COVID-19 pandemic: Guidance from the British Society of Gastroenterology
Colin J Rees, James E East, Kofi Oppong, Andrew Veitch, Mark McAlindon, John Anderson, Bu Hayee, Cathryn Edwards, Alastair McKinlay, Ian Penman
Clinical Medicine Jul 2020, 20 (4) 352-358; DOI: 10.7861/clinmed.2020-0296
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  • Article
    • ABSTRACT
    • Background
    • General principles
    • Protecting patients and staff
    • COVID-19 screening testing to facilitate the resumption of endoscopy services
    • PPE and infection control measures
    • Guidance for specific endoscopy procedures
    • Future work
    • Conclusions
    • Acknowledgements
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