3
COVID response leads to innovative surgical pathway
Rebecca’s vaccination journey takes in Oxford and Wembley
C
linicians at the Trust have responded to the ongoing COVID-19 pandemic by establishing a novel surgical pathway for patients suffering from complicated gallstones in the bile duct.
Stones that slip out of the gall bladder and into the bile duct can cause obstruction leading to serious conditions including pancreatitis, jaundice and abnormal liver function tests and, in some cases, can be fatal.
Streamlined referral To ensure the safe management of patients during the ongoing pandemic, a new streamlined referral pathway has been introduced to easily refer patients with pancreatitis due to gallstones, and patients presenting with possible common bile duct stones causing possible bile duct obstruction. In most UK hospitals bile duct patients are treated by first having a scan of the pancreas, liver and bile ducts, called a magnetic resonance cholangiogram. If this shows stones within the bile duct the patient then has an endoscopic procedure to remove the stones. The patient will then need to return to hospital to have the gallbladder removed (cholecystectomy) to prevent further recurrence.
Reducing potential exposure to COVID-19 The new pathway means the only imaging required before surgery for most patients will be an ultrasound to confirm the presence of gallstones. This approach reduces the need for the MRI and ERCP (which is an aerosol generating procedure) avoiding extra admissions and a reduction in potential exposure of patients and staff to COVID-19. Mr Alberto Martinez-Isla, Consultant Laparoscopic Upper GI Surgeon says: “The Trust is a leading centre for laparoscopic bile duct exploration and prior to COVID-19 was performing around 50-70 procedures a year. The impact of the pandemic has required a redesign of our care pathways to enable non-COVID patients to continue to have timely and safe access to surgery.” Mr Stuart Gould, Clinical Lead for Emergency Surgery and Deputy Divisional Director of Surgery says: “In responding to the pandemic it is crucial that we make our hospital services available and safe for nonCOVID patients and our staff. This novel pathway will help to manage a complex group of patients during the second wave of the pandemic and beyond. It is a very efficient process for treating patients who require urgent surgery to avoid the risk of their condition recurring and possible severe complications.”
T
ransfusion practitioner Rebecca Patel was among the first to volunteer to take part in the Oxford vaccination trials when they were announced in spring 2020. When the Wembley vaccination centre opened its doors in January 2021, volunteers were requested to help in supporting staff and community vaccinations, with Rebecca once again happy to put herself forward. Here she tells Our Trust about her reasons for getting involved: “During the first wave of the pandemic, I responded to the call for staff to take part in the Oxford trials. I think I knew, even back then, that our only hope of beating this virus would be a vaccine. ”When the vaccine was approved, it was the best news I’d heard for a long time and am so proud to have been a part of the research into producing it. “I’m still on the trial, going for regular blood tests and swabbing myself for COVID weekly. I’m not sure how much longer the trial will go on for, but I’m more than happy to continue for as long as they need me. “When an email went out asking for volunteers to start vaccinating staff at Northwick Park Hospital, I put myself forward immediately. It was fantastic to see so many staff coming forward for their jabs. And I was again delighted to offer to help at the Wembley centre when it opened in mid-January.
Members of the surgical team at Ealing Hospital
“I supervise and train volunteers, including medical students, to give the injection and healthcare professionals who help patients with the consent process, as well as drawing-up the injections.
“When the doors first opened at Wembley it warmed my heart to see how eager our elderly population were to get their vaccine and the pure joy on their faces. Some of them hadn’t been out of their houses for months and made this first special trip to get their jab. They are so brave and should be seen as role models for those who can’t decide whether or not to have the vaccine.”
What’s up doc? Our children’s ward Jack’s Place has taken on two special team members whose motto is “hop to it”. Rabbits Flip and Flop are now on hand to provide patients with some light relief. The furry friends were donated by a member of staff, and when not on the ward have the run of the outdoor play area.
Flip and Flop ready for action
