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Laparoscopic cholecystectomy during pregnancy

Review of anesthetic management, surgical considerations

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Abstract

Background: We present our experience with laparoscopic cholecystectomy in pregnant patients, with consideration of the physiological changes of pregnancy affecting anesthetic and surgical management.

Methods: We reviewed the medical records of all pregnant patients undergoing laparoscopic surgery at Brigham and Women's Hospital between January 1, 1991 and April 30, 1995.

Results: Laparoscopic cholecystectomy was performed without complication in ten patients (gestational age 9–30 weeks). Details of anesthetic and surgical management are described. The anesthetic and surgical implications of pregnancy-associated physiological changes in the gastrointestinal, respiratory, cardiovascular, and central nervous system are reviewed.

Conclusions: With appropriate attention to the altered physiology of pregnancy, laparoscopic cholecystectomy can be performed safely and effectively during pregnancy.

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References

  1. Basso L, McCollum PT, Darling MR, Tocchi A, Tanner WA (1992) A study of cholelithiasis during pregnancy and its relationship with age, parity, menarche, breast-feeding, dysmenorrhea, oral contraception and a maternal history of cholelithiasis. Surg Gynecol Obstet 175: 41–46

    Google Scholar 

  2. Braverman DZ, Johnson ML, Kern F Jr (1980) Effects of pregnancy and contraceptive steroids on gallbladder function. N Engl J Med 302: 362–364

    Google Scholar 

  3. Cheek TG, Gutsche BB (1993) Maternal physiologic alterations during pregnancy. In: Shnider SM, Levinson G (eds) Anesthesia for obstetrics. Williams and Wilkins, Baltimore, pp 3–19

    Google Scholar 

  4. Cunningham AJ, Brull SJ (1993) Laparoscopic cholecystectomy: anesthetic implications. Anesth Analg 76: 1120–1133

    Google Scholar 

  5. de la Torre R, Brooks DC, Becker JM (1993) Open trocar insertion facilitates laparoscopic cholecystectomy and decreases morbidity. Surg Laparosc Endosc 3: 269

    Google Scholar 

  6. DeSimone CA, Leighton BL, Norris MC, Chayen B, Menduke H (1988) The chronotropic effect of isoproterenol is reduced in term pregnant women. Anesthesiology 69: 626–628

    Google Scholar 

  7. Dixon NP, Faddis DM, Silberman H (1987) Aggressive management of cholecystitis during pregnancy. Am J Surg 154: 292–294

    Google Scholar 

  8. Glenn F, McSherry CK (1968) Gallstones and pregnancy among 300 young women treated by cholecystectomy. Surg Gynecol Obstet 127: 1067–1072

    Google Scholar 

  9. Hiatt JR, Hiatt JC, Williams RA, Klein SR (1986) Biliary disease in pregnancy: strategy for surgical management. Am J Surg 151: 263–265

    Google Scholar 

  10. Hunter JG, Swanstrom L, Thornburg K (1995) Carbon dioxide pneumoperitoneum induces fetal acidosis in a pregnant ewe model. Surg Endosc 9: 272–279

    Google Scholar 

  11. Joris JL, Noirot DP, Legrand MJ, Jacquet NJ, Lamy ML (1993) Hemodynamic changes during laparoscopic cholecystectomy. Anesth Analg 76: 1067–1071

    Google Scholar 

  12. Levinson G, Shnider SM, deLorimier AA, Steffenson JL (1974) Effects of maternal hyperventilation on uterine blood flow and fetal oxygenation and acid-base status. Anesthesiology 40: 340–347

    Google Scholar 

  13. Machi J, Sigel B, McGarth EC, Beitler JC, Ramos JR, Work BA Jr (1985) Operative ultrasonography in the biliary tract during pregnancy. Surg Gynecol Obstet 160: 119–123

    Google Scholar 

  14. Martin LVH, Jurand A (1992) The absence of teratogenic effects of some analgesics used in anaesthesia. Anaesthesia 47: 473–476

    Google Scholar 

  15. Mazze R, Källén B (1989) Reproductive outcome after anesthesia and operation during pregnancy: a registry study of 5405 cases. Am J Obstet Gynecol 16: 1178–1185

    Google Scholar 

  16. McKellar DP, Anderson CT, Boynton CJ (1992) Cholecystectomy during pregnancy without fetal loss. Surg Gynecol Obstet 174: 465–468

    Google Scholar 

  17. Palahniuk RJ, Shnider SM, Eger EI III (1974) Pregnancy decreases the requirements for inhaled anesthetic agents. Anesthesiology 41: 82

    Google Scholar 

  18. Soper NJ, Brunt LM, Kerbl K (1994) Laparoscopic general surgery. N Engl J Med 330: 409–419

    Google Scholar 

  19. Soper NJ, Hunter JG, Petrie RH (1992) Laparoscopic cholecystectomy during pregnancy. Surg Endosc 6: 115–117

    Google Scholar 

  20. Taylor E, Feinstein R, White PF, Soper N (1992) Anesthesia for laparoscopic cholecystectomy. Is nitrous oxide contraindicated? Anesthesiology 76: 541–543

    Google Scholar 

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Authors and Affiliations

  1. Department of Anesthesia, Brigham and Women's Hospital and Harvard Medical School, 75 Francis Street, 02115, Boston, MA, USA

    R. A. Steinbrook & S. Datta

  2. Department of Surgery, Brigham and Women's Hospital and Harvard Medical School, 75 Francis Street, 02115, Boston, MA, USA

    D. C. Brooks

Authors
  1. R. A. Steinbrook
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  2. D. C. Brooks
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  3. S. Datta
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Steinbrook, R.A., Brooks, D.C. & Datta, S. Laparoscopic cholecystectomy during pregnancy. Surg Endosc 10, 511–515 (1996). https://doi.org/10.1007/BF00188397

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  • DOI: https://doi.org/10.1007/BF00188397

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