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Gallstone Disease in Pregnancy

  • Michael R. Cox
Chapter

Abstract

The management of symptomatic gallstones during pregnancy is difficult, as there is limited evidence to support clinical decision making. Published guidelines exist with recommendations based on the best evidence available [1]. Other authors have attempted to do complex decision making analysis and modelling to determine the best care [2]; nonetheless, there is very little comparative data. Most of the data comes from reported case series with only 277 cases of laparoscopic cholecystectomy in pregnancy reported until 2007 [2]. Despite this, symptomatic gallstones are the second most frequent acute presentation in pregnant women, after acute appendicitis (Kant, [3]). However, the incidence is still low, with 0.05–0.8% of all pregnancies developing symptomatic gall stones [4–7].

References

  1. 1.
    Pearl J, Price R, Richardson W, Fannelli R. Guidelines for the diagnosis, Rx and use of laparoscopy for surgical problems in pregnancy. Surg Endosc. 2011;25:3479–92.CrossRefPubMedGoogle Scholar
  2. 2.
    Jelin EB, Smink DS, Vernon AH, Brooks DC. Management of biliary tract disease during pregnancy: a decision analysis. Surg Endosc. 2008;22:54–60.CrossRefPubMedGoogle Scholar
  3. 3.
    Kammerer W. Non-obstetric surgery during pregnancy. Med Clin N Am. 1979;63:115–63.CrossRefGoogle Scholar
  4. 4.
    Scott LD. Gallstone disease and pancreatitis in pregnancy. Gastrointest Clin N Am. 1992;21:803–15.Google Scholar
  5. 5.
    McKellar DP, Anderson CT, Boynton CT, Peoples JB. Cholecystectomy during pregnancy without fetal loss. Surg Gynecol Obstet. 1992;172:465–8.Google Scholar
  6. 6.
    Ko CW. Risk factors for gallstone related hospitalisation during pregnancy and the post-partum. Am J Gastroenterol. 2006;101:2263–8.CrossRefPubMedGoogle Scholar
  7. 7.
    Swisher SC, Schmitt PJ, Hunt KK, et al. Biliary disease during pregnancy. Am J Surg. 1994;168:576–81.CrossRefPubMedGoogle Scholar
  8. 8.
    Ghumman E, Barry M, Grace PA. Management of gallstones in pregnancy. Br J Surg. 1997;84:1646–50.CrossRefPubMedGoogle Scholar
  9. 9.
    Date RS, Kaushal M, Ramesh A. A review of the management of gallstone disease and its complications in pregnancy. Am J Surg. 2008;196:599–608.CrossRefPubMedGoogle Scholar
  10. 10.
    Hyatt JR, Gordon-Hyatt JC, Williams RA, Kair SR. Biliary disease in pregnancy: strategy for surgery. Am J Surg. 1986;151:263–5.CrossRefGoogle Scholar
  11. 11.
    Green J, Rogers A, Rubin L. Fetal loss after cholecystectomy during pregnancy. Can Med Assoc J. 1963;88:576–7.Google Scholar
  12. 12.
    Lanzafame RJ. Laparoscopic cholecystectomy during pregnancy. Surgery. 1995;118:627–33.CrossRefPubMedPubMedCentralGoogle Scholar
  13. 13.
    Cosenza CA, Saffari B, Jabbour N, Stain SC, Carry D, Parek D, Selby RA. Surgical management of biliary gallstone disease during pregnancy. Am J Surg. 1999;178:545–7.CrossRefPubMedGoogle Scholar
  14. 14.
    Dupar R, Simaldone GM, Hamad GG. Is there a benefit to delaying cholecystectomy for symptomatic gallbladder disease during pregnancy? Surg Endosc. 2010;24:108–12.CrossRefGoogle Scholar
  15. 15.
    Barone JE, Bears S, Chen S, Tsai J, Russell JC. Outcome study of cholecystectomy during pregnancy. Am J Surg. 1999;177:232–6.CrossRefPubMedPubMedCentralGoogle Scholar
  16. 16.
    Affleck DG, Handrahan DL, Egger DAJ, Price RR. The laparoscopic management of appendicitis and cholelithiasis during pregnancy. Am J Surg. 1999;178:523–9.CrossRefPubMedPubMedCentralGoogle Scholar
  17. 17.
    Kuy SR, Roman SA, Desai R, Sosa JA. Outcomes following cholecystectomy in pregnant women and non-pregnant women. Surgery. 2009;146:358–66.CrossRefPubMedGoogle Scholar
  18. 18.
    Porras LTC, Napoli ED, Camillan CM, Quesada BM, He R, Rodrigues JA, Uria AS. Minimally invasive treatment of acute biliary tract disease during pregnancy. HPB Surg. 2009;2009:829020.Google Scholar
  19. 19.
    Sedaghat N, Cao AM, Eslick GD, Cox MR. Laparoscopic verses open cholecystectomy in pregnancy: systematic review and meta-analysis. Surg Endosc. 2016;31:673–9.CrossRefPubMedGoogle Scholar
  20. 20.
    Visser BC, Glastow RE, Muluhicc KK, Mulvihill SJ. Safety and timing of non-obstetric surgery in pregnancy. Dig Surg. 2001;18:409–17.CrossRefPubMedGoogle Scholar
  21. 21.
    Nagaraja V, Eslick GD, Cox MR. Systematic review and meta-analysis of minimally invasive techniques for the management of cholecysto-choledocholithiasis. J Hepatobiliary Pancreat Sci. 2014;21:896–901.CrossRefPubMedPubMedCentralGoogle Scholar
  22. 22.
    Williams EJ, Green J, Beckingham I, Parks R, Martin D, Lombard M. Guidelines on the management of common bile duct stones. Gut. 2008;57:1004–21.CrossRefPubMedGoogle Scholar
  23. 23.
    Cao AM, Eslick GD, Cox MR. Early cholecystectomy is superior to delayed cholecystectomy for acute cholecystitis: a meta-analysis. J Gastrointest Surg. 2015;19:848–57.CrossRefPubMedPubMedCentralGoogle Scholar
  24. 24.
    Cao AM, Eslick GD, Cox MR. Early laparoscopic cholecystectomy is superior to delayed laparoscopic cholecystectomy for acute cholecystitis: a meta-analysis of case controlled studies. Surg Endosc. 2016;30:1172–82.CrossRefPubMedPubMedCentralGoogle Scholar
  25. 25.
    Welschbillig-Meurier K, Pessau K, Lebigot J, Lermite E, Aube C, et al. Percutaneous cholecystectomy for high-risk patients with acute cholecystitis. Surg Endosc. 2005;19:1256–9.CrossRefGoogle Scholar
  26. 26.
    Spira RM, Nissan A, Xamir O, Cohen T, Fields SI, Freund HA. Percutaneous transhepatic cholecystostomy and delayed laparoscopic cholecystectomy in critically ill patients with acute calculous cholecystitis. Am J Surg. 2002;183:62–6.CrossRefPubMedPubMedCentralGoogle Scholar
  27. 27.
    Leveau P, Anderson E, Carlgren I, Willner J, Anderson R. Percutaneous cholecystostomy: a bridge to surgery or definitive management of acute cholecystitis in high-risk patients. Scand J Gastroenterol. 2008;43:593–6.CrossRefPubMedGoogle Scholar
  28. 28.
    Tseng JY, Yang MJ, Yang CC, Chao KC, Li HY. Acute cholecystitis during pregnancy: what is the best approach? Taiwan J Obstet Gynaecol. 2009;48:305–7.CrossRefGoogle Scholar
  29. 29.
    Allmendinger N, Hallisey MJ, Ohki SK, Straub JJ. Percutaneous cholecystostomy treatment of acute cholecystitis in pregnancy. Obstet Gynaecol. 1995;86:653–4.CrossRefGoogle Scholar
  30. 30.
    Wilkinson EJ. Acute pancreatitis in pregnancy: a review of 98 cases and a report of 8 new cases. Obstet Gynaecol Surg. 1973;28:281–303.CrossRefGoogle Scholar
  31. 31.
    Jouppila P, Mokka R, Larmi TK. Acute pancreatitis in pregnancy. Surg Gynecol Obstet. 1974;139:879–82.PubMedGoogle Scholar
  32. 32.
    Banks PA, Bollen TL, Peruems C, Goostan HG, Johnson CD, Sarr MG, Tsiotos GG, Vege SS. Classification of acute pancreatitis—2012: revision of the Atlanta classification and definitions by international consensus. Gut. 2013;62:102–11.CrossRefPubMedPubMedCentralGoogle Scholar

Copyright information

© Springer International Publishing AG, part of Springer Nature 2018

Authors and Affiliations

  1. 1.Nepean Clinical School University of SydneySydneyAustralia

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