Acute Pancreatitis and Pregnancy: A 10-Year Single Center Experience



Acute pancreatitis in pregnancy is rare. We report our institutional therapeutic approaches to this disease and its effect on maternal and fetal outcomes.


A retrospective review of medical records of pregnant women admitted to Brigham and Women’s Hospital between 1996 and 2006.


Twenty-one patients, presenting with 34 episodes of acute pancreatitis were identified. Most attacks (56%) occurred in the second trimester. Twelve patients had biliary pancreatitis. Three had pancreatitis secondary to other causes and six had “undetermined” etiologies. Of those with biliary pancreatitis, six underwent cholecystectomy; in a third of these cases, initial conservative therapy had failed. The other six patients underwent endoscopic sphincterotomy (n = 2) or conservative therapy (n = 4). Fifty percent of the patients with biliary pancreatitis managed conservatively had a recurrent episode of pancreatitis vs none in the cholecystectomy group. There was no significant difference in length of hospital stay between the three treatment groups (cholecystectomy, sphincterotomy, and conservative therapy). No maternal deaths were observed; there were four preterm labors and one fetal loss.


If treated conservatively, pregnant patients with biliary pancreatitis appear to have a high recurrence rate. Early surgical intervention is appropriate, safe, and does not increase the length of hospital stay.

This is a preview of subscription content, log in to check access.

Access options

Buy single article

Instant unlimited access to the full article PDF.

US$ 39.95

Price includes VAT for USA


  1. 1.

    McKay AJ, O’Neill J, Imrie CW. Pancreatitis, pregnancy and gallstones. Br J Obstet Gynaecol 1980;87:47–50.

  2. 2.

    Ramin KD, Ramin SM, Richey SD, Cunningham FG. Acute pancreatitis in pregnancy. Am J Obstet Gynecol 1995;173:187–191.

  3. 3.

    Dreiling DA, Bordalo O, Rosenberg V, Rudick J. Pregnancy and pancreatitis. Am J Gastroenterol 1975;64:23–25.

  4. 4.

    Ramin KD, Ramsey PS. Disease of the gallbladder and pancreas in pregnancy. Obstet Gynecol Clin North Am 2001;28:571–580.

  5. 5.

    Corlett RC, Mishell DR. Pancreatitis in pregnancy. Am J Obstet Gynecol 1972;113:281–290.

  6. 6.

    Swisher SG, Hunt KK, Schmit PJ, Hiyama DT, Bennion RS, Thompson JE. Management of pancreatitis complicating pregnancy. Am Surg 1994;60:759–762.

  7. 7.

    Jamidar PA, Beck GJ, Hoffman BJ, Lehman GA, Hawes RH, Agrawal RM, Ashok PS, Ravi TJ, Cunningham JT, Troiano F, Sherman S, Brodmerkel GJ. Endoscopic retrograde cholangiopancreatography in pregnancy. Am J Gastroenterol 1995;90:1263–1267.

  8. 8.

    May GR, Shaffer EH. Should elective endoscopic sphincterotomy replace cholecystectomy for the treatment of high-risk patients with gallstone pancreatitis? J Clin Gastroenterol 1991;13:125–128.

  9. 9.

    Barthel JS, Chowdhury T, Miedema BW. Endoscopic sphincterotomy for the treatment of gallstone pancreatitis during pregnancy. Surg Endosc 1998;12:394–399.

  10. 10.

    Kahaleh M, Hartwell GD, Arseneau KO, Pajewski TN, Mullick T, Isin G, Agarwal S, Yeaton P. Safety and efficacy of ERCP in pregnancy. Gastrointest Endosc 2004;60:287–292.

  11. 11.

    Bradley EL. A clinically based classification system for acute pancreatitis. Summary of the International Symposium on Acute Pancreatitis, Atlanta, GA, September 11–13, 1992. Arch Surg 1993;128:586–590.

  12. 12.

    Wilkinson EJ. Acute pancreatitis in pregnancy: A review of 98 cases and a report of 8 new cases. Obstet Gynecol Surv 1973;28:281–303.

  13. 13.

    Langmade CF, Edmondson HA. Acute pancreatitis during pregnancy and the postpartum period; a report of nine cases. Surg Gynecol Obstet 1951;92:43–52.

  14. 14.

    Montgomery WH, Miller FC. Pancreatitis and pregnancy. Obstet Gynecol 1970;35:658–664.

  15. 15.

    Maringhini A, Lankisch MR, Zinsmeister AR, Melton LJ 3rd, DiMagno EP. Acute pancreatitis in the postpartum period: A population-based case-control study. Mayo Clin Proc 2000;75:361–364.

  16. 16.

    Ko CW. Risk factors for gallstone-related hospitalization during pregnancy and the postpartum. Am J Gastroenterol 2006;101:2263–2268.

  17. 17.

    Maringhini A, Ciambra M, Baccelliere P, Raimondo M, Orlando A, Tine F, Grasso R, Randazzo MA, Barresi L, Gullo D, Musico M, Pagliaro L. Biliary sludge and gallstones in pregnancy: Incidence, risk factors, and natural history. Ann Intern Med 1993;119:116–120.

  18. 18.

    Valdivieso V, Covarrubias C, Siegel F, Cruz F. Pregnancy and cholelithiasis: Pathogenesis and natural course of gallstones diagnosed in early puerperium. Hepatology 1993;17:1–4.

  19. 19.

    Menees S, Elta G. Endoscopic retrograde cholangiopancreatography during pregnancy. Gastrointest Endosc Clin N Am 2006;16:41–57.

  20. 20.

    Scott LD. Gallstone disease and pancreatitis in pregnancy. Gastroenterol Clin North Am 1992;21:803–815.

  21. 21.

    Banks PA, Freeman ML; Practice Parameters Committee of the American College of Gastroenterology. Practice guidelines in acute pancreatitis. Am J Gastroenterol 2006;101:2379–2400.

  22. 22.

    Mayer AD, McMahon MJ, Benson EA, Axon AT. Operations upon the biliary tract in patients with acute pancreatitis: Aims, indications and timing. Ann R Coll Surg Engl 1984;66:179–183.

  23. 23.

    Paloyan D, Simonowitz D, Skinner DB. The timing of biliary tract operations in patients with pancreatitis associated with gallstones. Surg Gynecol Obstet 1975;141:737–739.

  24. 24.

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

  25. 25.

    Gurbuz AT, Peetz ME. The acute abdomen in the pregnant patient. Is there a role for laparoscopy? Surg Endosc 1997;11:98–102.

  26. 26.

    Cohen-Kerem R, Railton C, Oren D, Lishner M, Koren G. Pregnancy outcome following non-obstetric surgical intervention. Am J Surg 2005;190:467–473.

  27. 27.

    Rollins MD, Chan KJ, Price RR. Laparoscopy for appendicitis and cholelithiasis during pregnancy: A new standard of care. Surg Endosc 2004;18:237–241.

  28. 28.

    Bisharah M, Tulandi T. Laparoscopic surgery in pregnancy. Clin Obstet Gynecol 2003;46:92–97.

  29. 29.

    Tham TC, Vandervoort J, Wong RC, Montes H, Roston AD, Slivka A, Ferrari AP, Lichtenstein DR, Van Dam J, Nawfel RD, Soetikno R, Carr-Locke DL. Safety of ERCP during pregnancy. Am J Gastroenterol 2003;98:308–311.

  30. 30.

    Makary MA, Duncan MD, Harmon JW, Freeswick PD, Bender JS, Bohlman M, Magnuson TH. The role of magnetic resonance cholangiography in the management of patients with gallstone pancreatitis. Ann Surg 2005;241:119–124.

  31. 31.

    Liu CL, Fan ST, Lo CM, Tso WK, Wong Y, Poon RT, Lam CM, Wong BC, Wong J. Comparison of early endoscopic ultrasonography and endoscopic retrograde cholangiopancreatography in the management of acute biliary pancreatitis: A prospective randomized study. Clin Gastroenterol Hepatol 2005;3:1238–1244.

  32. 32.

    Neoptolemos JP, Raraty M, Finch M, Sutton R. Acute pancreatitis: The substantial human and financial costs. Gut 1998;42:886–891.

Download references

Author information

Correspondence to Ali Tavakkolizadeh.

Additional information

This study was presented in part at the Digestive Disease Week 2007, Washington, DC.

Rights and permissions

Reprints and Permissions

About this article

Cite this article

Hernandez, A., Petrov, M.S., Brooks, D.C. et al. Acute Pancreatitis and Pregnancy: A 10-Year Single Center Experience. J Gastrointest Surg 11, 1623–1627 (2007) doi:10.1007/s11605-007-0329-2

Download citation


  • Acute pancreatitis
  • Pregnancy
  • Cholecystectomy
  • Gallstones