COVID-19 - Guidelines on emergency, urgent and elective measures
The American College of Surgeons has issued guidelines for the triage of metabolic and bariatric surgery (MBS) patients, as part of its Coronavirus Disease 2019 (COVID-19) and Surgery online resource for the surgical community facing the impact of COVID-19.
The content has been developed or curated under the auspices of ACS Regents and Officers to bring surgeons trusted information, including best practices and guidance that specifically target the concerns and challenges surgeons face. As the COVID-19 landscape is rapidly changing, this website is updated several times weekly and houses current and past editions of its electronic newsletter Bulletin: ACS COVID-19 Update.
Emergency (needs immediate action; life threatening or permanent organ damage)
- Patients in haemorrhagic shock
- Patients in septic shock
- Necrotizing soft tissue infections
- Perforated viscus
- Airway emergencies
- Risk of Ischemic bowel
- Specific Bariatric: Perforated marginal ulcer, bleeding, anastomotic or staple-line leak, obstruction particularly internal hernia, gastric band perforation or prolapse
Urgent (needs surgery; may be delayed by a few days/weeks)
- Bariatric: revisions for dysphagia, severe GERD, pain, dehydration/malnutrition, slipped band, anastomotic strictures at risk for aspiration
- Primary cases for patients pending surgery requiring preop weight loss ie transplant, etc.
Elective (may be delayed for months without threat to life or organ damage)
- Bariatric: primary gastric bypass, sleeve, duodenal switch, gastric band
- Revisions for weight gain
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