Delaying Cholecystectomy for Complicated Gallstone Disease in Pregnancy is Associated with Recurrent Postpartum Symptoms

Veerappan, Annapoorani; Gawron, Andrew J.; Soper, Nathaniel J.; Keswani, Rajesh N.

doi:10.1007/s11605-013-2330-2

Cited by 42 publications

(24 citation statements)

References 16 publications

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“…Symptomatic cholelithiasis can also lead to complicated biliary disease, including cholecystitis, pancreatitis, choledocholithiasis, and cholangitis. We have previously shown that delaying cholecystectomy for complicated gallstone disease results in early postpartum gallstonerelated symptoms and repeat hospitalizations [ 16 ]. However, there is little data regarding the outcomes for patients with uncomplicated symptomatic cholelithiasis (SC) in pregnancy.…”

Section: Introductionmentioning

confidence: 99%

Non-operative Management of Symptomatic Cholelithiasis in Pregnancy is Associated with Frequent Hospitalizations

Jorge¹,

Keswani²,

Veerappan³

et al. 2015

Journal of Gastrointestinal Surgery

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Symptomatic cholelithiasis (SC) is common in pregnancy. Guidelines recommend laparoscopic cholecystectomy (LC) for SC in pregnancy. Our aim was to evaluate current practice patterns and outcomes for patients undergoing initial non-operative management for uncomplicated SC during pregnancy. We performed a retrospective analysis and telephone survey of all patients presenting in a 42-month period to a tertiary care center for uncomplicated SC during pregnancy. Women with complicated gallstone disease, including cholecystitis, pancreatitis, choledocholithiasis, and cholangitis were excluded. We identified 53 patients with uncomplicated SC during pregnancy. LC was performed in 4 (7.5%) antepartum and in 28 (51.7%) postpartum. The majority of LCs (21, 75%) were performed within 3 months postpartum. Of those with postpartum LC, 22 (78.6%) had recurrent postpartum symptoms prior to LC, and 14 (50%) had repeat hospitalizations prior to undergoing surgery. Given the safety of antepartum LC and the frequency of recurrent symptoms and hospitalizations, early surgical intervention during pregnancy may be the optimal strategy to reduce antepartum and early postpartum admissions for uncomplicated SC.

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Section: Introductionmentioning

confidence: 99%

Non-operative Management of Symptomatic Cholelithiasis in Pregnancy is Associated with Frequent Hospitalizations

Jorge¹,

Keswani²,

Veerappan³

et al. 2015

Journal of Gastrointestinal Surgery

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“…Patients treated with nonoperative management are at a significant risk for recurrent symptoms; during the third trimester, if surgery is not performed, antepartum ERCP and endoscopic sphincterotomy appear to be protective with a decrease of symptom recurrence, but early postpartum cholecystectomy is strongly recommended [88][89][90]. In case of severe AP, most often due to hypertriglyceridemia, and life-threatening for the mother and fetus, a pregnancy interruption is mandatory, as soon as possible, either by abortion or by delivery if possible [91].…”

Section: Acute Pancreatitis and Pregnancymentioning

confidence: 99%

Acute Pancreatitis

Campli¹,

Cerioli²,

Leppäniemi³

et al. 2016

Emergency Laparoscopy

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“…There are no extensive prospective studies addressing perinatal outcomes or clinical trials on this topic. However, several small studies have shown laparoscopic cholecystectomy during pregnancy to be generally safe for mother and foetus [75].…”

Section: Acute Cholecystitis In Pregnancymentioning

confidence: 99%