Non-Operative Management of Cholecystitis in Pregnant Patients Remains Common

Area of Science:

• Medical Interventions
• Obstetrics
• Gastroenterology

Background:

• Cholecystectomy is the standard treatment for acute cholecystitis during pregnancy.
• Previous studies indicate underutilization of surgical management despite recommendations.
• Data on cholecystostomy tube use and outcomes in pregnant patients are limited.

Purpose of the Study:

• To investigate trends in cholecystitis interventions during pregnancy.
• To compare outcomes of different management strategies, including cholecystectomy and cholecystostomy tube placement.
• To identify potential barriers to optimal treatment.

Main Methods:

• Analysis of the National Readmissions Database (2016-2019).
• Inclusion criteria: patients with cholecystitis and pregnancy.
• Data collected: demographics, gestational age, intervention rates (cholecystectomy, cholecystostomy), readmissions, and complications.

Main Results:

• Intervention rates for cholecystitis in pregnancy remained low (27.0%-34.9%) during the study period.
• 6.0% of patients initially managed non-operatively underwent cholecystectomy upon readmission.
• Intervention likelihood varied by trimester, being higher in the second and lower in the third trimester.

Conclusions:

• Cholecystectomy rates in pregnant patients are low, despite its established safety.
• Cholecystostomy tube placement is a viable, safe alternative, but associated with longer hospital stays.
• Further research is necessary to understand and address barriers to adequate cholecystitis treatment in pregnancy.