Adamsen S, Jacobsen B, Bentzon N
Hillerød Sygehus, kirurgisk afdeling A.
Ugeskr Laeger. 1993 Jul 12;155(28):2215-6.
Pregnancy has been considered an absolute contraindication to laparoscopic cholecystectomy, but recently several successful cases have been published. Two patients operated upon during the second trimester with an uneventful intra- and postoperative course and subsequent uncomplicated obstetric course are reported. The procedure requires special consideration with respect to incisions, insertion of cannula and ports, establishment and maintenance of pneumoperitoneum with a pressure of 10 mmHg, intraoperative monitoring of maternal end-tidal pCO2, perioperative foetal monitoring and choice of postoperative analgesics. The use of intraoperative cholangiography is controversial, but it should probably be avoided in pregnant patients. It is not known whether perioperative tocolytic therapy is necessary. Laparoscopic cholecystectomy is not contraindicated during pregnancy.
妊娠一直被视为腹腔镜胆囊切除术的绝对禁忌证，但最近已有数例成功病例发表。本文报告了2例在孕中期接受手术的患者，术中及术后过程顺利，随后产科过程也无并发症。该手术在切口、套管和端口的插入、建立并维持10 mmHg压力的气腹、术中监测母体呼气末二氧化碳分压、围手术期胎儿监测以及术后镇痛药物的选择等方面需要特别考虑。术中胆管造影的使用存在争议，但在孕妇中可能应避免使用。围手术期是否需要使用宫缩抑制剂尚不清楚。妊娠期间腹腔镜胆囊切除术并非禁忌。
