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Mini-Laparoscopic Cholecystectomy During the Late Second and Third Trimesters of Pregnancy
Hadrien Tranchart1,2, Celeste Del Basso1,2, Alexandre Vivanti3,2
1Minimally Invasive Digestive Surgery, Antoine-Béclère Hospital, Clamart, FRA.
Background:
Mini-laparoscopic cholecystectomy (MLC) reduces abdominal wall injury and has the advantage of not altering the surgical principles of conventional laparoscopic cholecystectomy. Our team recently decided to extend the indications for mini-laparoscopy to pregnant women requiring cholecystectomy in the late second and third trimesters when significant uterine height is a potential difficulty.
Methods:
From January 2022, all patients who underwent MLC after five months of pregnancy were included in the analysis. Operative, postoperative, and perinatal outcomes were retrospectively collected.
Results:
Ten patients underwent MLC between 24 and 32 weeks of gestation. The mean operative time was 73 ± 24 minutes. Only one minor intraoperative complication was observed. The mean postoperative pain, quality of life, and cosmetic satisfaction at the first postoperative visit were 1.8 ± 0.9, 9.1 ± 0.8, and 9.5 ± 0.8, respectively. Finally, all patients had an uncomplicated vaginal delivery. No preterm delivery or fetal loss occurred.
Conclusions:
These preliminary results suggest that the mini-laparoscopy could be used safely in selected pregnant women requiring cholecystectomy even after five months of gestation. By preserving the abdominal wall as much as possible, MLC may be of particular interest in this particular case, when the patient's abdominal wall could potentially be subjected to severe secondary stress in the event of vaginal delivery.
