Management of gallstones in pregnancy.

BACKGROUND

Biliary disease during pregnancy is rare and the management of cholecystitis during pregnancy is controversial. Cholecystectomy in the pregnant patient has generally been avoided because of the reported high incidence of associated fetal loss. Recent developments relating to diagnostic and anaesthetic management have altered the overall approach to symptomatic biliary tract disease in pregnant patients.

METHODS

The literature was reviewed using Medline searches for cholelithiasis in pregnancy, to include pathophysiology, diagnosis and management.

RESULTS AND CONCLUSION

Surgery should be performed only for complicated non-resolving biliary tract disease during pregnancy as in over 90 per cent of patients the acute process will resolve with conservative management. For patients requiring operative intervention, laparoscopic cholecystectomy has emerged as a safe and effective method of treatment.