Laparoscopy for appendicitis and cholelithiasis during pregnancy: a new standard of care

Original article

Abstract

Background: Subsequent to a report from the authors’ institution, the laparoscopic management of symptomatic cholelithiasis and appendicitis during pregnancy has become the standard of care at LDS Hospital using institutional guidelines. For comparison with previous outcomes described by the authors, 59 additional laparoscopic cases are reported. Methods: Medical records of all pregnant patients at LDS Hospital who underwent open or laparoscopic cholecystectomy or appendectomy between 1998 and 2002 were reviewed. The outcomes were compared with the authors’ previous data. Results: The laparoscopic management of symptomatic cholelithiasis and appendicitis during pregnancy increased from 54% to 97%. No significant differences in preterm delivery rates, birth weights, or 5-min Apgar scores were found between the two periods. No birth defects or uterine injuries occurred. Conclusions: With the use of the authors’ guidelines, laparoscopy has become the standard of care for managing symptomatic cholelithiasis and appendicitis during pregnancy at LDS Hospital without significant increase in morbidity or mortality.

Keywords

Pregnancy Laparoscopy Cholecystectomy Appendectomy 

References

  1. 1.
    Affleck, DG, Handrahan, DL, Egger, MJ, Price, RR 1999The laparoscopic management of appendicitis and cholelithiasis during pregnancy.Am J Surg178523529CrossRefPubMedGoogle Scholar
  2. 2.
    Al-Fozan, H, Tulandi, T 2002Safety and risks of laparoscopy in pregnancy.Curr Opin Obstet Gynecol14375379CrossRefPubMedGoogle Scholar
  3. 3.
    Ames Castro, M, Shipp, TD, Castro, EE, Ouzounian, J, Rao, P 2001The use of helical computed tomography in pregnancy for the diagnosis of acute appendicitis.Am J Obstet Gynecol184954957CrossRefPubMedGoogle Scholar
  4. 4.
    Cosenza, CA, Saffari, B, Jabbour, N, Stain, SC, Carry, D, Parekh, D, Selby, RR 1999Surgical management of biliary gallstone disease during pregnancy.Am J Surg178545548CrossRefPubMedGoogle Scholar
  5. 5.
    Curet, MJ 2000Special problems in laparoscopic surgery: previous abdominal surgery, obesity, and pregnancy.Surg Clin North Am8010931110PubMedGoogle Scholar
  6. 6.
    Curet, MJ, Allen, D, Josloff, RK, Pitcher, DE, Curet, LB, Miscall, BG, Zucker, KA 1996Laparoscopy during pregnancy.Arch Surg131546550discussion 550–541PubMedGoogle Scholar
  7. 7.
    Davis, A, Katz, VL, Cox, R 1995Gallbladder disease in pregnancy.J Reprod Med40759762PubMedGoogle Scholar
  8. 8.
    Fatum, M, Rojansky, N 2001Laparoscopic surgery during pregnancy.Obstet Gynecol Surv565059PubMedGoogle Scholar
  9. 9.
    Glasgow, RE, Visser, BC, Harris, HW, Patti, MG, Kilpatrick, SJ, Mulvihill, SJ 1998Changing management of gallstone disease during pregnancy.Surg Endosc12241246CrossRefPubMedGoogle Scholar
  10. 10.
    Graham, G, Baxi, L, Tharakan, T 1998Laparoscopic cholecystectomy during pregnancy: a case series and review of the literature.Obstet Gynecol Surv53566574CrossRefPubMedGoogle Scholar
  11. 11.
    Gurbuz, AT, Peetz, ME 1997The acute abdomen in the pregnant patient: is there a role for laparoscopy?Surg Endosc1198102CrossRefPubMedGoogle Scholar
  12. 12.
    Hiatt, JR, Hiatt, JC, Williams, RA, Klein, SR 1986Biliary disease in pregnancy: strategy for surgical management.Am J Surg151263265PubMedGoogle Scholar
  13. 13.
    Kammerer, WS 1979Nonobstetric surgery during pregnancy.Med Clin North Am6311571164PubMedGoogle Scholar
  14. 14.
    Kort, B, Katz, VL, Watson, WJ 1993The effect of nonobstetric operation during pregnancy.Surg Gynecol Obstet177371376PubMedGoogle Scholar
  15. 15.
    Lemaire, BM, van Erp, WF 1997Laparoscopic surgery during pregnancy.Surg Endosc111518CrossRefPubMedGoogle Scholar
  16. 16.
    Lim, HK, Bae, SH, Seo, GS 1992Diagnosis of acute appendicitis in pregnant women: value of sonography.AJR Am J Roentgenol159539542Google Scholar
  17. 17.
    Reedy, MB, Kallen, B, Kuehl, TJ 1997Laparoscopy during pregnancy: a study of five fetal outcome parameters with use of the Swedish Health Registry.Am J Obstet Gynecol177673679PubMedGoogle Scholar
  18. 18.
    Scott, LD 1992Gallstone disease and pancreatitis in pregnancy.Gastroenterol Clin North Am21803815Google Scholar
  19. 19.
    Society of American Gastrointestinal Endoscopic Surgeons (SAGES)1998Guidelines for laparoscopic surgery during pregnancy.Surg Endosc12189190Google Scholar
  20. 20.
    State-specific changes in singleton preterm births among black and white women—United States, 1990 and 19972000.MMWR Morb Mortal Wkly Rep49837840Google Scholar

Copyright information

© Springer-Verlag 2003

Authors and Affiliations

  1. 1.Department of SurgeryLDS Hospital, 8th Avenue and C Street, Salt Lake City, UT 84143USA
  2. 2.Statistical Data CenterLDS Hospital, 8th Avenue and C Street, Salt Lake City, UT 84143USA

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