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

Article Figures & Data

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