Wishner J D, Zolfaghari D, Wohlgemuth S D, Baker J W, Hoffman G C, Hubbard G W, Gould R J, Ruffin W K
Department of Surgery, Eastern Virginia Medical School, Norfolk, USA.
Surg Endosc. 1996 Mar;10(3):314-8. doi: 10.1007/s004649910049.
Although pregnancy was initially considered an absolute contraindication to laparoscopic cholecystectomy, there have been several case reports of successful laparoscopic cholecystectomy in pregnant patients in the literature over the past 4 years. We report our experience with six patients managed successfully with laparoscopic cholecystectomy during pregnancy.
More than 1,300 laparoscopic cholecystectomies were performed by the Norfolk Surgical Group between May 1991 and June 1994. Six of these patients (approximately 0.5%) were operated on during pregnancy. We reviewed the management and operative technique used in these patients compared to our standard approach. The available literature was reviewed to identify any other factors which might be helpful in the management of these patients.
In this series we were able to perform laparoscopic cholecystectomy successfully in all six patients in whom it was attempted, with an overall course similar to that of nonpregnant patients. There were no significant complications to the patient or the fetus. All six patients have delivered healthy children and continue to do well.
With the addition of our 6 patients, there have been 32 successful laparoscopic cholecystectomies during pregnancy reported in the English literature. We feel laparoscopic cholecystectomy can be performed safely in pregnant patients and should be considered in any patient who presents with symptomatic cholelithiasis during pregnancy.
尽管妊娠最初被视为腹腔镜胆囊切除术的绝对禁忌证，但在过去4年的文献中已有数例关于妊娠患者成功进行腹腔镜胆囊切除术的病例报告。我们报告我们对6例在妊娠期成功接受腹腔镜胆囊切除术患者的治疗经验。
诺福克外科小组在1991年5月至1994年6月期间进行了1300多例腹腔镜胆囊切除术。其中6例患者（约0.5%）在妊娠期接受了手术。我们将这些患者的治疗和手术技术与我们的标准方法进行了比较。查阅了现有文献以确定可能有助于治疗这些患者的任何其他因素。
在本系列中，我们对所有6例尝试进行腹腔镜胆囊切除术的患者均成功实施了该手术，总体病程与非妊娠患者相似。患者和胎儿均未出现重大并发症。所有6例患者均已产下健康婴儿，且情况良好。
加上我们的6例患者，英文文献中已报道了32例妊娠期成功进行的腹腔镜胆囊切除术。我们认为腹腔镜胆囊切除术可在妊娠患者中安全实施，对于妊娠期出现症状性胆石症的任何患者均应考虑该手术。
