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Cholecystectomy during pregnancy without fetal loss
D P McKellar1, C T Anderson, C J Boynton
1Department of Surgery, United States Air Force Medical Center, Wright-Patterson Air Force Base, Dayton, Ohio.
Surgery, Gynecology & Obstetrics
|June 1, 1992
Summary
Cholecystectomy during pregnancy is safe, with no increased fetal loss. Modern management allows safe surgical treatment for gallstones in pregnant patients, eliminating the need for delayed therapy.
Area of Science:
- Obstetrics and Gynecology
- Surgical Gastroenterology
- Maternal-Fetal Medicine
Background:
- Cholecystectomy in pregnancy was historically avoided due to high fetal loss risks.
- Advancements in diagnostics, anesthesia, and tocolytic agents have improved patient management.
Purpose of the Study:
- To evaluate the safety and outcomes of cholecystectomy in pregnant patients.
- To determine if delaying surgery for gallstones in pregnancy is necessary.
Main Methods:
- Retrospective review of 22 pregnant patients with cholelithiasis from 1982-1987.
- Analysis of surgical timing, procedures (including common bile duct exploration and cholangiograms), and pregnancy outcomes.
Main Results:
- Nine patients underwent cholecystectomy during pregnancy (across all trimesters) with no fetal loss.
- Premature contractions occurred in two patients but were managed with tocolytic agents.
- Neonatal Apgar scores were comparable to those of mothers who deferred surgery.
Conclusions:
- Cholelithiasis can be safely diagnosed and surgically treated in pregnant patients.
- Delaying necessary surgical intervention for gallstones in pregnancy is not warranted.