Laparoscopic or Open Cholecystectomy for Acute Cholecystitis During Pregnancy? A Tunisian Surgery Center’s Experience

Mahjoubi, Mohamed Farès; Marrakchi, M.; Rezgui, Bochra; Essid, Nada; Karoui, Yasser; Moussa, Mounir Ben; Dhaou, Anis Ben

doi:10.1007/s12262-023-03710-6

Cited by 1 publication

(1 citation statement)

References 5 publications

Supporting

Mentioning

Contrasting

Order By: Relevance

“…In addition, there is less manipulation of the uterus. It also reduces deep vein thrombosis in the postoperative period and reduces the risk of abortion in the first trimester and prematurity in the third trimester [23,24].…”

Section: Discussionmentioning

confidence: 99%

Acute cholecystitis in pregnant women: A therapeutic challenge in a developing country center

Mahjoubi,

Dhaou,

Maatouk

et al. 2023

Ann Hepatobiliary Pancreat Surg

View full text Add to dashboard Cite

Acute cholecystitis is a rare condition in pregnant women, potentially affecting the maternal and fetal prognosis. Our aim was to report the main clinical and paraclinical features of acute cholecystitis during pregnancy and therapeutic modalities. Methods: We conducted a case series analysis recording pregnant patients with acute cholecystitis admitted to our surgery department over a period of 11 years. We collected clinical data, paraclinical features, and management modalities related to cholecystitis. Results: There were 47 patients. Twenty-eight percent was in the first trimester of pregnancy, 40% in the second, and 32% in the third trimester. Abdominal pain was located in the right hypochondrium in 75% of cases. Fever was noted in 21% of cases. C-reactive protein was elevated in 39% of patients. Cholestasis markers were high in four patients. Abdominal ultrasound showed a distended gallbladder in 39 patients, with thickened wall in 34 patients, and gallbladder lithiasis in all cases. No patient had a dilated main bile duct. All patients received intravenous antibiotic therapy. Tocolysis was indicated in 32 patients. Laparoscopic cholecystectomy was performed in 32 cases (68%), and open cholecystectomy in 15 cases (32%). Postoperative course was uneventful in 42 patients, and complicated in 5 patients. Rate of complications was statistically higher after open cholecystectomy (p = 0.003). Morbidity rate was higher in the third trimester (p = 0.003). Conclusions: Delay in the diagnosis of acute cholecystitis during pregnancy can lead to serious complications. Management is based on antibiotic therapy and cholecystectomy. Laparoscopic cholecystectomy appears to be less morbid than open cholecystectomy.

show abstract

Section: Discussionmentioning

confidence: 99%