Comitalo J B, Lynch D
Department of Surgery, United States Air Force Medical Center, Scott Air Force Base, Illinois 62225-5252.
Surg Laparosc Endosc. 1994 Aug;4(4):268-71.
Laparoscopic cholecystectomy has rapidly replaced open cholecystectomy as the preferred surgical treatment of symptomatic cholelithiasis. Although the indications are similar for both procedures, some surgeons believe that pregnancy is a contraindication for the laparoscopic approach. Several recent reports in the literature have shown that laparoscopic cholecystectomy can be performed safely in the pregnant patient. A review of all patients who underwent laparoscopic cholecystectomy from January 1991 to January 1993 at Scott Air Force Base (AFB) and Edwards AFB was performed. Of 248 patients reviewed, four procedures were performed in the gravid patient. All patients were operated on during the second trimester of pregnancy. Laparoscopic cholecystectomy was successful in all four. Cholangiogram was performed in two patients. No postoperative morbidity was encountered (maternal or fetal). Twenty-one cases of laparoscopic cholecystectomy in the pregnant patient, with no fetal or maternal morbidity or mortality, have been reported in the literature to date. We conclude that in selected cases, laparoscopic cholecystectomy can be performed safely during pregnancy.
腹腔镜胆囊切除术已迅速取代开腹胆囊切除术，成为有症状胆结石首选的手术治疗方法。尽管这两种手术的适应症相似，但一些外科医生认为妊娠是腹腔镜手术的禁忌症。最近文献中的几份报告显示，孕妇也可安全地进行腹腔镜胆囊切除术。我们回顾了1991年1月至1993年1月在斯科特空军基地（AFB）和爱德华兹空军基地接受腹腔镜胆囊切除术的所有患者。在248例接受回顾的患者中，有4例是孕妇。所有患者均在妊娠中期接受手术。4例患者的腹腔镜胆囊切除术均获成功。2例患者进行了胆管造影。未出现术后并发症（母体或胎儿）。迄今为止，文献中已报道21例孕妇接受腹腔镜胆囊切除术，无胎儿或母体发病或死亡情况。我们得出结论，在特定情况下，妊娠期间可安全地进行腹腔镜胆囊切除术。
