Laparoscopic cholecystectomy during pregnancy.

BACKGROUND: Cholecystectomy represents the second most common nonobstetric operation during pregnancy. Published guidelines for laparoscopic cholecystectomy (LC) have considered it to be contraindicated in the gravid patient. Several cases of successful LCs in the gravid patient have been reported recently. This study reviews LC during pregnancy in my series and compares this experience with the published literature.

METHODS: Five LCs were performed during pregnancy out of 380 cases between May 1990 and November 1994. Forty-one cases were retrieved via MEDLINE search.

RESULTS: Three patients were in their second trimester (14, 17, and 22 weeks), and two patients were in the third trimester (27.5 and 28 weeks) in my series. The open technique was used in one patient. Intraoperative cholangiography was not performed. No maternal or fetal morbidity occurred. Forty-one cases have been reported in the literature. Four patients were operated on during the first trimester, 35 during the second trimester, and two during the third trimester (range, 3 to 31 weeks) without fetal loss or maternal morbidity. Cholangiography was performed in 15 cases. Tocolytic agents were used in five of 46 patients.

CONCLUSIONS: Although additional clinical data are required, laparoscopic cholecystectomy is safe during pregnancy when undertaken by the skilled laparoscopic surgeon.