Cholecystectomy During the Third Trimester of Pregnancy: Proceed or Delay?

Fong, Zhi Ven; Pitt, Henry A.; Strasberg, Steven M.; Molina, Rose L.; Perez, Numa P.; Kelleher, Cassandra M.; Loehrer, Andrew P.; Sicklick, Jason K.; Talamini, Mark A.; Lillemoe, Keith D.; Chang, David C.

doi:10.1016/j.jamcollsurg.2018.12.024

Cited by 44 publications

(34 citation statements)

References 26 publications

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“…'s study which demonstrated increasing risks of adverse perinatal outcomes with advanced trimesters, 2 as well as results from Fong et al . 's study which found that cholecystectomies performed during the third trimester were associated with worse outcomes including preterm delivery, eclampsia and haemorrhage 13 . The difference in observation between these studies and ours could be partly due to the low number of patients who underwent surgery in the third trimester (10.4%), as well as the potential discrepancies in the nature of surgeries performed.…”

Section: Discussioncontrasting

confidence: 63%

Evaluation of safety and foeto‐maternal outcome following non‐obstetric surgery in pregnancy: a retrospective single‐site Australian study

Choi

Arafat

et al. 2021

ANZ Journal of Surgery

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We conducted a retrospective study to evaluate the safety of non‐obstetric surgery during pregnancy by studying 106 pregnant women who underwent non‐obstetric surgery at a regional Australian hospital over a 10‐year period. The study showed that maternal and foetal outcomes were comparable to that of the general population. Subgroup analysis did not demonstrate any statistically significant differences between groups, except for an increased rate of delivery by caesarean section in pregnant women who underwent laparotomy compared to those who underwent laparoscopy.

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Section: Discussioncontrasting

confidence: 63%

Evaluation of safety and foeto‐maternal outcome following non‐obstetric surgery in pregnancy: a retrospective single‐site Australian study

Choi

Arafat

et al. 2021

ANZ Journal of Surgery

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“…The second most common reason for surgical intervention during pregnancy in our study was adnexal pathology, including one case of pediculated leiomyoma, the third was cholecystolithiasis [17][18][19][20][21][22][23][24][25].…”

Section: Discussionmentioning

confidence: 75%

“…Symptomatic gallstone disease in pregnancy has been reported to be related to increased mortality risk for both the mother and fetus [17,20]. Cholecystolithiasis was diagnosed by using ultrasound (USG).…”

Section: Discussionmentioning

confidence: 99%

“…The American College of Obstetricians and Gynecologists published guidelines that proposed imperative consultation with obstetricians prior to nonobstetric surgery and other invasive procedures (e.g., coronary angiography or colonoscopy) because obstetricians are uniquely qualified to discuss aspects of maternal physiology and anatomy that may affect intraoperative maternal and fetal well being [8]. The study of Fong et al focused on surgical interventions during the third trimester of pregnancy, giving the general recommendation that they should be avoided whenever possible [20]. In our study, 22% (17 cases) of all interventions were made the in third trimester, and went without significant complications.…”

Section: Discussionmentioning

confidence: 99%

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Non-obstetric surgery during pregnancy – an eleven-year retrospective analysis

Vujić

Marsoner

Lipp-Pump

et al. 2019

BMC Pregnancy Childbirth

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Background: Diagnosis and management of non-obstetric abdominal pathologies during pregnancy are clinically challenging for both obstetricians and general surgeons. Our aim was to evaluate the outcome of pregnant patients who had undergone non-obstetric abdominal surgery. Methods: We retrospectively reviewed 76 pregnant patients who had required surgery for non-obstetric abdominal pathologies during pregnancy at our department from January 2005 to December 2015. Data were collected retrospectively from medical records as well as from our institutional perinatal database. We evaluated data for clinical presentation, perioperative management, preterm labor, and maternal and fetal outcomes. Results: The patients' mean age was 29 (interquartile range IQR 25-33) years. Indications for surgery were acute appendicitis in 63%, adnexal pathology in 11%, cholecystolithiasis in 5% and other indications in 21%; surgery was performed in an elective setting in 18% and in an emergent/urgent setting in 82%. In five cases, complications, three of them oncological, called for further surgery. Ninety-seven percent of operations were conducted under general anesthesia. Median skin-to-skin time was 50 (37-80) minutes, median in-hospital stay was 4 (3.5-6) days, and 5 % required postoperative intensive care. Preterm labor occurred in 15%, miscarriage in 7% (none of them directly related to abdominal surgery). Conclusion: Abdominal surgery for non-obstetric pathology during pregnancy can be performed safely, if mandatory, without increases in maternal and fetal pathology, miscarriage, and preterm birth rates.

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“…Cholecystectomy is generally not recommended in the third trimester as it is associated with increased preterm delivery. 14 The differential diagnosis for abdominal pain is extensive and while most patients have a single pathology, general surgeons must also consider that more than one disease process can occasionally be present at one time. In 1977, over an 8 year period, Black observed three cases of acute cholecystitis, alongside a second abdominal illness: acute appendicitis, small bowel obstruction and acute diverticulitis, respectively.…”

Section: Discussionmentioning

confidence: 99%

Acute gangrenous appendicitis and acute gangrenous cholecystitis in a pregnant patient, a difficult diagnosis: a case report

et al. 2021

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Abdominal pain is a common complaint in pregnancy, especially given the physiological and anatomical changes that occur as the pregnancy progresses. The diagnosis and treatment of common surgical pathologies can therefore be difficult and limited by the special considerations for the fetus. While uncommon in the general population, concurrent or subsequent disease processes should be considered in the pregnant patient. We present the case of a 36 year old, 13 weeks pregnant female who presented with both acute appendicitis and acute cholecystitis.

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Cholecystectomy During the Third Trimester of Pregnancy: Proceed or Delay?

Cited by 44 publications

References 26 publications

Evaluation of safety and foeto‐maternal outcome following non‐obstetric surgery in pregnancy: a retrospective single‐site Australian study

Evaluation of safety and foeto‐maternal outcome following non‐obstetric surgery in pregnancy: a retrospective single‐site Australian study

Non-obstetric surgery during pregnancy – an eleven-year retrospective analysis

Acute gangrenous appendicitis and acute gangrenous cholecystitis in a pregnant patient, a difficult diagnosis: a case report

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