alexa Laparoscopic cholecystectomy in pregnancy.
Diabetes & Endocrinology

Diabetes & Endocrinology

Pancreatic Disorders & Therapy

Author(s): Gouldman JW, Sticca RP, Rippon MB, McAlhany JC Jr

Abstract Share this page

Abstract Laparoscopic cholecystectomy has been performed in the United States since 1989 and currently is the procedure of choice for the management of symptomatic cholelithiasis. Its utility in the pregnant patient has been controversial. Concerns have been expressed for a number of potential problems, including trocar injury to uterus and fetus, effect of pneumoperitoneum on both mother and fetus, induction of preterm labor, teratogenic effects on the fetus, and long-term effects on fetal and neonatal development. We describe the Greenville Hospital System experience with laparoscopic cholecystectomy in pregnancy. From 1992 to 1996, eight laparoscopic cholecystectomies were performed in pregnant females, one during the first trimester and seven during the second trimester. Mean maternal age was 23.8 years (range, 18-31). All procedures were performed for recurrent and intractable symptoms with the average length of symptoms 3.5 weeks (range, 2-4 weeks). Two patients were diagnosed preoperatively with gallstone pancreatitis, two had acute cholecystitis, and four patients were felt to have hyperemesis gravidarum before their diagnosis of gallstones. All procedures were performed under general endotracheal anesthesia with CO2 insufflation pressures of 12 mm Hg. Postoperatively, all patients had uneventful recoveries with complete resolution of their symptoms and were discharged home in an average of 3 days (range, 1-7 days). No postoperative complications to mother or fetus were documented. Eight patients have delivered full-term healthy fetuses with no documented neonatal morbidity or mortality. Long-term follow-up of the infants at a mean of 23 months (range, 2.5-47 months) reveals that all eight infants have progressed to normal healthy children. Our experience and the current world literature demonstrate that laparoscopic cholecystectomy in pregnancy can be performed safely and effectively for symptomatic cholelithiasis, especially when symptoms are recurrent and persistent and may endanger fetal and maternal livelihood. The diagnosis of symptomatic cholelithiasis should be considered in the pregnant patient with recurrent episodes of nausea and vomiting.
This article was published in Am Surg and referenced in Pancreatic Disorders & Therapy

Relevant Expert PPTs

Relevant Speaker PPTs

Recommended Conferences

Relevant Topics

Peer Reviewed Journals
 
Make the best use of Scientific Research and information from our 700 + peer reviewed, Open Access Journals
International Conferences 2017-18
 
Meet Inspiring Speakers and Experts at our 3000+ Global Annual Meetings

Contact Us

 
© 2008-2017 OMICS International - Open Access Publisher. Best viewed in Mozilla Firefox | Google Chrome | Above IE 7.0 version
adwords