Laparoscopic surgery for symptomatic cholelithiasis during pregnancy

Area of Science:

• Surgical innovation in obstetrics and gynecology
• Minimally invasive surgery
• Gastrointestinal surgery

Background:

• Cholecystectomy is the second most common nonobstetric surgery during pregnancy.
• Laparoscopic cholecystectomy is increasingly the standard of care for symptomatic cholelithiasis in pregnancy.
• Traditional restrictions favoring open surgery are being re-evaluated.

Purpose of the Study:

• To provide additional evidence on the efficacy and safety of laparoscopic cholecystectomy during pregnancy.
• To demonstrate the safety and effectiveness of laparoscopic cholecystectomy, particularly in the first trimester of pregnancy.

Main Methods:

• Analysis of 10 cases of laparoscopic cholecystectomy performed during pregnancy at King Abdullah University Hospital (KAUH).
• Review of medical records, follow-up of deliveries, and analysis of outcomes.
• Comparison of results with existing literature.

Main Results:

• Ten laparoscopic cholecystectomies were performed across various gestational ages (5 first trimester, 3 second, 2 third).
• No maternal or fetal mortality or anomalies were reported.
• One case of stillbirth occurred in a patient who refused surgical intervention for recurrent biliary colic.

Conclusions:

• Laparoscopic cholecystectomy is safe throughout all stages of pregnancy when performed by skilled surgeons.
• The procedure is associated with low mortality and morbidity.
• First-trimester symptomatic cholelithiasis can be safely managed laparoscopically, with no observed interference with organogenesis or early uterine contractions.