[Laparoscopic cholecystectomy in the third trimester of pregnancy]

Two patients in the third trimester of pregnancy were subjected to laparoscopic cholecystectomy for the treatment of symptomatic gallstone disease. Indications for the procedure were acute cholecystitis in the first case and biliary pancreatitis associated to recurrent biliary pain in the second one. The operations were done without hemodinamic or anesthetic complications to the pregnants and fetus. The mean operative time was 22 minutes. Although suggested that visualization of the anatomic structures of the superior abdomen could be difficult in the third trimester, we did not find problems for dissection and visualization of structures including cystic duct and cystic artery. Both patients were discharged 24 hours after the procedures and until the present description, remain with no related complications. Laparoscopic cholecystectomy, when strictly necessary, can be safely done and is of proven effectiveness in surgical management of symptomatic gallstone disease during third trimester of pregnancy. It is related to a very low index of complications and does not present difficulties concerning access and exposure of intrabdominal structures.