Navigating gallstones in pregnancy: a case of surgical precision and obstetric vigilance
DOI:
https://doi.org/10.18203/2320-1770.ijrcog20254313Keywords:
Gallstones, Pregnancy, ERCP, Laparoscopic cholecystectomy, Biliary stentingAbstract
Gallstone disease during pregnancy poses clinical challenges due to altered physiology and concerns over fetal safety. We present the case of a 28-year-old primigravida who had undergone endoscopic retrograde cholangiopancreatography (ERCP) with biliary stenting for choledocholithiasis prior to conception. She remained asymptomatic during early pregnancy, with normal liver function and no signs of cholecystitis on magnetic resonance cholangiopancreatography (MRCP). After multidisciplinary evaluation, laparoscopic cholecystectomy was performed during the second trimester using fetal-safe anaesthetic techniques and open abdominal access. The procedure was uneventful, and recovery was smooth. She later delivered a healthy term infant via spontaneous vaginal delivery at 37 weeks. This case supports the growing evidence that laparoscopic cholecystectomy, when carefully timed and executed, is a safe and effective treatment for gallstone disease in pregnancy.
Metrics
References
Barone JE, Bears S, Chen S, Tsai J, Russell JC. Outcome study of cholecystectomy during pregnancy. Am J Surg. 1999;177(3):232-6. DOI: https://doi.org/10.1016/S0002-9610(99)00007-0
Amoli HA, Tavakoli H, Notash AY, Far MS, Khashayar P. Laparoscopic cholecystectomy during pregnancy: A case series. J Minimal Access Surg. 2008;4(1):9-14. DOI: https://doi.org/10.4103/0972-9941.40991
Chamogeorgakis T, Lo Menzo E, Smink RD, Feuerstein B, Fantazzio M, Kaufman J, et al. Laparoscopic cholecystectomy during pregnancy: three case reports. JSLS. 1999;3(1):67-9.
Wishner JD, Zolfaghari D, Wohlgemuth SD, Baker JW, Hoffman GC, Hubbard GW, et al. Laparoscopic cholecystectomy in pregnancy. A report of 6 cases and review of the literature. Surg Endosc. 1996;10(3):314-8. DOI: https://doi.org/10.1007/s004649910049
Rampersad FS, Chan A, Persaud S, Maharaj P, Maharaj R. Choledocholithiasis in Pregnancy: A Case Report. Cureus. 2022;14(2):e22610. DOI: https://doi.org/10.7759/cureus.22610
Daradkeh S, Sumrein I, Daoud F, Zaidin K, Abu-Khalaf M. Management of gallbladder stones during pregnancy: conservative treatment or laparoscopic cholecystectomy? Hepatogastroenterology. 1999;46(30):3074-6.
Sungler P, Heinerman PM, Steiner H, Waclawiczek HW, Holzinger J, Mayer F, et al. Laparoscopic cholecystectomy and interventional endoscopy for gallstone complications during pregnancy. Surg Endosc. 2000;14(3):267-71. DOI: https://doi.org/10.1007/s004640000037
Heller MT, Tublin ME, Hosseinzadeh K, Fargiano A. Imaging of hepatobiliary disorders complicating pregnancy. AJR Am J Roentgenol. 2011;197(3):W528-536. DOI: https://doi.org/10.2214/AJR.10.5128
Graham G, Baxi L, Tharakan T. Laparoscopic Cholecystectomy During Pregnancy: A Case Series and Review of the Literature. Obstet Gynecol Surv. 1998;53(9):566-74. DOI: https://doi.org/10.1097/00006254-199809000-00024
Ward D, Hashmi DL, Zhitnikov S. Successful laparoscopic cholecystectomy at 32 weeks of pregnancy-A case report. Int J Surg Case Rep. 2021;84:106119. DOI: https://doi.org/10.1016/j.ijscr.2021.106119