Pregnancy: A Contraindication?

Holthausen, U.; Mettler, Liselotte; Troidl, H.

doi:10.1007/s002689900589

Cited by 37 publications

(17 citation statements)

References 48 publications

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“…In many minds, pregnancy is still considered to be a contraindication and physicians have a tendency to postpone surgical intervention for as long as possible, best until after delivery [13,14]. However preterm delivery, birth defects, 5-min Apgar score, and low-birth-weight after laparoscopic appendicectomy or cholecystectomy are possible without significant increase in morbidity or mortality [15,16]. We present here our experience in laparoscopic management of acute appendicitis and symptomatic biliary colic in the pregnant women.…”

Section: Introductionmentioning

confidence: 99%

Laparoscopic management of appendicitis and symptomatic cholelithiasis during pregnancy

Halkic

Tempia-Caliera

Ksontini

et al. 2006

Langenbecks Arch Surg

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Background Laparoscopic surgery during pregnancy is a challenging procedure that most surgeons are reluctant to perform. The objective of this study was to evaluate whether laparoscopic appendectomy and cholecystectomy is safe in pregnant women. The management of these situations remains controversial. We report a single center study describing the successful management of 16 patients during pregnancy. Methods More than 3,356 laparoscopic procedures were performed in our institutions between May 1990 and June 2005. Sixteen of these patients were operated on in the second and third trimester between 22 and 32 weeks of estimated gestational age. We performed 11 laparoscopic appendectomies and 5 laparoscopic cholecystectomies. We also reviewed the management and operative technique used in these patients. Results In this study, the laparoscopic appendectomy or cholecystectomy was performed successfully in all patients. Three patients were in their second trimester, weeks 22, 23, and 25, and 13 were in the third trimester, weeks 27 (three patients), 28 (five patients), 31 (three patients), and 32 (two patients). No maternal or fetal morbidity occurred. Open laparoscopy was performed safely in all patients and all patients delivered healthy babies.Conclusion From our experience laparoscopic management of appendicitis and biliary colic during pregnancy is safe, however the second trimester is preferable for laparoscopic cholecystectomy. Pregnancy is not a contraindication to the laparoscopic approach to appendicitis or symptomatic cholelithiasis. We believe that laparoscopic operations, when performed by experienced surgeons, are safe and even preferable for the mother and the fetus.

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Section: Introductionmentioning

confidence: 99%

Laparoscopic management of appendicitis and symptomatic cholelithiasis during pregnancy

Halkic

Tempia-Caliera

Ksontini

et al. 2006

Langenbecks Arch Surg

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“…As laparoscopy became adopted by general surgeons and gynecologists for non-obstetric procedures, controversy grew over optimal approaches to the treatment of acute appendicitis in the pregnant patient. Pregnancy was initially considered a contraindication to laparoscopy [87] and subsequent papers questioned whether laparoscopic appendectomy was feasible in pregnant patients [88]. Challenges of performing laparoscopy during pregnancy include difficult visualization due to gravid uterus with laparoscope and potential risk of decreased blood flow due to increased intraabdominal pressure, possible carbon dioxide absorption for the mother or fetus [89].…”

Section: Controversies In Surgical Managementmentioning

confidence: 99%

Review of Operative vs. Non-Operative Management of Appendicitis in Pregnancy

Blears¹,

Keller²,

Ellis³

2017

Surgery Curr Res

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The last decade has marked a paradigm shift in the care for acute appendicitis in children and non-pregnant adults. Although surgical management remains the safest treatment modality for perforated or complicated appendicitis, antibiotic therapy has been proven to be safe in adult and pediatric patients with non-perforated appendicitis. However, controversy exists for the type of surgery (laparoscopic vs. open) and the post-operative antibiotic regimens which result in optimal patient care of pregnant as well as non-pregnant adults. As several authors have begun to evaluate a non-operative strategy for treating acute appendicitis, whether with antibiotic therapy alone or combined with image-guided percutaneous drainage, others have retrospectively analyzed these strategies to pregnant women with abdominal pain. This collective review presents the epidemiology and diagnostic challenges of acute appendicitis in the pregnant patient and a review of the data that supports non-operative management in non-pregnant adults and pediatric patients as well as the limited data that supports non-operative management in pregnant adults.

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“…Die Schwangerschaft im 1. und 2. Trimester stellt keine Kontraindikation für ein laparoskopisches Vorgehen mehr dar [9,28,53,63].…”

Section: Diskussionunclassified

Offene vs. laparoskopische Appendektomie

Lippert

Koch

Marusch

et al. 2002

Chirurg

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This article discusses the question of whether open or laparoscopic appendectomy is preferable in today's clinical routine. The article is based on data from randomized studies, evaluation of meta-analyses, and data from nonrandomized, multicentric studies evaluating the treatment of appendicitis in routine clinical practice. According to the data analysis, open appendectomy (OA) offers advantages with regard to a significantly shorter operative time and lower hospital costs. Laparoscopic appendectomy (LA) is characterized by a significantly decreased rate of failed septic wound healing and faster recovery. Both procedures can be performed with the same degree of safety and comparable outcome for acute appendicitis. Laparoscopic appendectomy offers significant advantages for establishing a precise diagnosis in young fertile women and overweight patients suffering from lower abdominal pain. The currently available data do not provide precise guidelines for the treatment of perforating appendicitis. However, we found significant evidence indicating an increased rate of postoperative intra-abdominal abscess after laparoscopic appendectomy. Thus, a laparoscopic approach cannot be regarded as a standard technique in advanced appendicitis.

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Pregnancy: A Contraindication?

Cited by 37 publications

References 48 publications

Laparoscopic management of appendicitis and symptomatic cholelithiasis during pregnancy

Laparoscopic management of appendicitis and symptomatic cholelithiasis during pregnancy

Review of Operative vs. Non-Operative Management of Appendicitis in Pregnancy

Offene vs. laparoskopische Appendektomie

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