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[Laparoscopic cholecystectomy in pregnant patient: experience in hospital General de Mexico in a period of 5 years (2008-2012)].

作者信息

del Avila-Silva María Rocío, Zavala-Castillo Julio César, Coronel-Cruz Fausto Moisés

出版信息

Ginecol Obstet Mex. 2014 Aug;82(8):509-17.

Abstract

BACKGROUND

Cholecystitis is the second cause of abdominal pain during pregnancy. 1-8 of 10,000 requiring surgery, being performed in the first and second quarter laparoscopically. 100% of patients with cholecystitis, about 12% are associated with pancreatitis with high rates of maternal and fetal morbidity and mortality.

OBJECTIVE

To evaluate advantages--disadvantages of maternal-fetal pregnancy laparoscopic cholecystectomy and its preventive character avoiding cases of pancreatitis. We analyze the results obtained in Perinatology Service in General Hospital of Mexico (2008 to 2012) comparing them with the current literature.

MATERIAL AND METHODS

A retrospective, cross sectional, descriptive. Analyzing the following variables: maternal age, gestational age, number of gestations, surgical technique, and postoperative complications trans, maternal and perinatal morbidity, gallbladder colic episodes prior, liver ultrasound report--bile ducts, tocolytic management.

RESULTS

20 laparoscopic cholecystectomies were performed in pregnant patients. Maternal age 21-38 years, mostly multigesta. 5 patients was performed at weeks 9, 14, 20 and 25 between the SDG and 1 at 27.5 SDG.Vesicular colicky eight previous USG mostly with gallstones.Two cases of mild acute pancreatitis satisfactorily resolved. No trans or postoperative complications. Open technique for performing pneumoperitoneum (Hasson). Tocolytic management indomethacin in 100% of cases.

CONCLUSIONS

The results obtained are consistent with the current literature, confirming that laparoscopic cholecystectomy is the best treatment option with minimal fetal maternal morbidity, reducing the incidence of pancreatitis and maternal- fetal consequences.

摘要

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