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.