2815 Outcomes of Interventional Endoscopy for Gallstone Complications in Early Pregnancy

Abstract

INTRODUCTION: Endoscopic retrospective cholangiopancreatography (ERCP) is a technically challenging procedure rarely associated with severe post-procedure complications. Pregnancy promotes cholelithiasis due to hormonal changes and ERCP may be indicated. Surgical intervention is preferred during the second trimester of pregnancy. However, limited data is available on the safety of ERCP in early pregnancy. METHODS: Over a 7 year period, all pregnant patients with complicated gallstone disease were studied retrospectively at Loma Linda University Medical Center in California (n = 41). Five patients underwent ERCP during either the first or second trimester for choledocholithiasis or gallstone pancreatitis. One patient underwent laparascopic cholecystectomy during the same hospitalization. All patients underwent sphincterotomy and stone removal with balloon sweeps. Fluoroscopy was utilized in all five cases. RESULTS: Three patients delivered full term, healthy babies. Two of the patients experienced spontaneous abortions within one week after ERCP. Both cases of spontaneous abortion were in their first trimester of pregnancy. There were no other clear etiologies reported for cause of both abortions. CONCLUSION: ERCP is reported to be a relatively safe procedure in pregnancy. More studies are required to investigate the safety of ERCP in early pregnancy.