Acute Cholecystitis with Calculous Biliary Duct Obstruction in the Gravid Patient. Management by ERCP, Papillotomy, Stone Extraction, and Laparoscopic Cholecystectomy

Overview

Journal Surg Endosc

Publisher Springer

Specialties Gastroenterology
General Surgery
Radiology

Date 1995 Aug 1

PMID 8525447

Citations 6

Authors

R L Friedman

I H FRIEDMAN

Affiliations

Soon will be listed here.

Abstract

The pregnant patient with cholelithiasis is subject to the manifold complications associated with this disease. The management of a gravid patient with acute cholecystitis complicated by biliary duct obstruction utilizing combined endoscopic therapy and laparoscopic cholecystectomy is reported. The benefits to the patient and fetus when successful are apparent, but it is important to anticipate potential problems associated with laparoscopy in pregnancy and to avoid them. Various safeguards such as fetal monitoring, careful trocar placement, and intra-abdominal pressure monitoring have been suggested and should be appropriately utilized to enable a satisfactory outcome. Case reports such as this may further clarify the interdependent role of laparoscopic cholecystectomy and ERCP and their application to the pregnant patient.

Citing Articles

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Laparoscopic cholecystectomy in the new millennium.

Lichten J, REID J, Zahalsky M, Friedman R Surg Endosc. 2001; 15(8):867-72.

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References

Elerding S . Laparoscopic cholecystectomy in pregnancy. Am J Surg. 1993; 165(5):625-7. DOI: 10.1016/s0002-9610(05)80448-9. View

Nezhat F, Nezhat C, Silfen S, Fehnel S . Laparoscopic ovarian cystectomy during pregnancy. J Laparoendosc Surg. 1991; 1(3):161-4. DOI: 10.1089/lps.1991.1.161. View

Hill L, Johnson C, Lee R . Cholecystectomy in pregnancy. Obstet Gynecol. 1975; 46(3):291-3. View

McKellar D, Anderson C, Boynton C, Peoples J . Cholecystectomy during pregnancy without fetal loss. Surg Gynecol Obstet. 1992; 174(6):465-8. View

Barnett M, Liu D . Letter: Complication of laparoscopy during early pregnancy. Br Med J. 1974; 1(5903):328. PMC: 1633388. DOI: 10.1136/bmj.1.5903.328-b. View

Baillie J, Cairns S, Putman W, Cotton P . Endoscopic management of choledocholithiasis during pregnancy. Surg Gynecol Obstet. 1990; 171(1):1-4. View

Arvidsson D, Gerdin E . Laparoscopic cholecystectomy during pregnancy. Surg Laparosc Endosc. 1991; 1(3):193-4. View

Soper N . Effect of nonbiliary problems on laparoscopic cholecystectomy. Am J Surg. 1993; 165(4):522-6. DOI: 10.1016/s0002-9610(05)80954-7. View

Hart R, Tamadon A, Fitzgibbons Jr R, Fleming A . Open laparoscopic cholecystectomy in pregnancy. Surg Laparosc Endosc. 1993; 3(1):13-6. View

10.

Hiatt J, Hiatt J, Williams R, Klein S . Biliary disease in pregnancy: strategy for surgical management. Am J Surg. 1986; 151(2):263-5. DOI: 10.1016/0002-9610(86)90083-8. View

11.

Frazee R, Roberts J, Symmonds R, Hendricks J, Snyder S, Smith R . Combined laparoscopic and endoscopic management of cholelithiasis and choledocholithiasis. Am J Surg. 1993; 166(6):702-5; discussion 705-6. DOI: 10.1016/s0002-9610(05)80683-x. View

12.

Shaked G, Twena M, Charuzi I . Laparoscopic cholecystectomy for empyema of gallbladder during pregnancy. Surg Laparosc Endosc. 1994; 4(1):65-7. View

13.

GRAVES Jr H, Ballinger J, Anderson W . Appraisal of laparoscopic cholecystectomy. Ann Surg. 1991; 213(6):655-62; discussion 662-4. PMC: 1358599. DOI: 10.1097/00000658-199106000-00017. View

14.

Ghazi A, Washington M . Endoscopic retrograde cholangiopancreatography, endoscopic sphincterotomy, and biliary drainage. Surg Clin North Am. 1989; 69(6):1249-74. DOI: 10.1016/s0039-6109(16)44987-x. View

15.

Edelman D . Alternative laparoscopic technique for cholecystectomy during pregnancy. Surg Endosc. 1994; 8(7):794-6. DOI: 10.1007/BF00593444. View

16.

Axelrad A, Fleischer D, Strack L, Benjamin S, Al-Kawas F . Performance of ERCP for symptomatic choledocholithiasis during pregnancy: techniques to increase safety and improve patient management. Am J Gastroenterol. 1994; 89(1):109-12. View

17.

Basso L, McCollum P, Darling M, Tocchi A, TANNER W . A study of cholelithiasis during pregnancy and its relationship with age, parity, menarche, breast-feeding, dysmenorrhea, oral contraception and a maternal history of cholelithiasis. Surg Gynecol Obstet. 1992; 175(1):41-6. View

18.

Chandra M, Shapiro S, Gordon L . Laparoscopic cholecystectomy in the first trimester of pregnancy. Surg Laparosc Endosc. 1994; 4(1):68-9. View

19.

Sorensen V, Bivins B, Obeid F, Horst H . Management of general surgical emergencies in pregnancy. Am Surg. 1990; 56(4):245-50. View

20.

Schreiber J . Laparoscopic appendectomy in pregnancy. Surg Endosc. 1990; 4(2):100-2. DOI: 10.1007/BF00591270. View