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Nan X, Chan E, Wong KSC, Ng J, Izwan S, Cooper M, Damodaran R. Laparoscopic Cholecystectomy in Pregnancy: A Seven-Year Retrospective Study From an Australian Tertiary Center. Cureus 2023; 15:e50034. [PMID: 38186520 PMCID: PMC10768355 DOI: 10.7759/cureus.50034] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 12/03/2023] [Indexed: 01/09/2024] Open
Abstract
Background Cholecystectomy is the second most common non-obstetric indication for surgery during pregnancy; however, there is little recent literature specifically exploring perioperative care approaches, and a paucity of Australian data exists. This study investigates the incidence of laparoscopic cholecystectomy (LC) during pregnancy, peri-operative management, and post-operative outcomes in a single Australian tertiary center. Methods A retrospective analysis of LCs performed on pregnant patients between the ages of 16 and 50 years at a tertiary hospital between 2016 and 2023 was completed. Results Twenty-three patients underwent LC. The median gestational age was 17+4 weeks (4+3-30+6). Cases were performed in all three trimesters, with the majority in the second trimester (n=12, 52.2%). Surgery indications were recurrent biliary colic (n=11, 47.8%), acute cholecystitis (n=8, 34.8%), and gallstone pancreatitis (n=4, 17.4%). Obstetrics and Gynecology (O&G) consultations occurred in 56.5% (n=13) of cases. Fetal heart rate (FHR) was recorded perioperatively in 82.6% (n=19) of cases. Preoperative steroids were given to 40% of eligible patients. An intraoperative cholangiogram was performed in 12 (52.2%) cases, of which eight (66.7%) utilized abdominal shielding. There was no perioperative maternal mortality nor fetal loss. Surgical morbidities were pancreatitis (n=1), bile leak (n=1), and intraoperatively recognized bile duct injury (n=1). Two threatened preterm labors and five (26.3%) preterm deliveries occurred. Conclusion Performing LC in pregnancy does carry a risk of major morbidity; however, there was no mortality or fetal loss across all trimesters. The decision to perform abdominal shielding during an intraoperative cholangiogram should be approached sensitively in a case-by-case manner, given recent paradigm shifts in radiology. A multidisciplinary approach with standardized local perioperative care policies regarding procedures such as O&G consultation, perioperative steroid use, and FHR monitoring is strongly recommended.
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Affiliation(s)
- Xinyi Nan
- General Surgery, Gold Coast Hospital and Health Service, Gold Coast, AUS
- School of Medicine and Dentistry, Griffith University, Gold Coast, AUS
| | - Erick Chan
- General Surgery, Gold Coast Hospital and Health Service, Gold Coast, AUS
- School of Medicine and Dentistry, Griffith University, Gold Coast, AUS
| | - Kok Sum Chloe Wong
- General Surgery, Gold Coast Hospital and Health Service, Gold Coast, AUS
| | - Justin Ng
- General Surgery, Gold Coast Hospital and Health Service, Gold Coast, AUS
- Faculty of Health Sciences and Medicine, Bond University, Gold Coast, AUS
| | - Sara Izwan
- General Surgery, Gold Coast Hospital and Health Service, Gold Coast, AUS
- School of Medicine and Dentistry, Griffith University, Gold Coast, AUS
| | - Michelle Cooper
- General Surgery, Gold Coast Hospital and Health Service, Gold Coast, AUS
| | - Ramesh Damodaran
- General Surgery, Gold Coast Hospital and Health Service, Gold Coast, AUS
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Takei Y, Eguchi Y, Yamauchi-Kawaura C, Suzuki S, Hirose E, Hirofuji Y, Honmoto T, Miyazaki O, Igarashi T, Shimada Y, Matsubara K. [The Report of Task Group of Gonadal Shield Discontinuing in Pediatric Hip and Pelvic Radiography in Japan]. Nihon Hoshasen Gijutsu Gakkai Zasshi 2022; 78:1495-1510. [PMID: 36543234 DOI: 10.6009/jjrt.2022-2123] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/23/2022]
Affiliation(s)
- Yasutaka Takei
- Department of Radiological Technology, Kawasaki University of Medical Welfare
| | - Yoshitaka Eguchi
- Division of Orthopaedic Surgery, National Center for Child Health and Development
| | | | - Shoichi Suzuki
- Department of Radiological Technology, Fujita Health University
| | - Etsuko Hirose
- Department of Radiology, Hyogo Prefectural Nishinomiya Hospital
| | - Yoshiaki Hirofuji
- Department of Radiological Sciences, School of Health Sciences, Fukushima Medical University
| | | | - Osamu Miyazaki
- Department of Radiology, National Center for Child Health and Development
| | - Takayuki Igarashi
- Department of Radiological Technology, International University of Health and Welfare, Narita Hospital
| | | | - Kosuke Matsubara
- Department of Quantum Medical Technology, Faculty of Health Sciences, Institute of Medical, Pharmaceutical and Health Sciences, Kanazawa University
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