Cholecystectomy in the Third Trimester: Delay Is Best for the Baby

We thank Tolcher and colleagues for their interest in our study.1 However, we disagree with their position that cholecyststectomy in the third trimester is safe for both the pregnant woman and the baby. In their review article,2 old, uncontrolled, and underpowered studies are quoted to justify their recommendation to proceed with surgery during pregnancy. These same inadequate studies were used to justify current guidelines.3 In comparison, our analysis of nearly 18,000 pregnant women undergoing cholecystectomy in the third trimester or the 90 days after delivery is properly controlled and powered to draw appropriate conclusions.
Source: Journal of the American College of Surgeons - Category: Surgery Authors: Tags: Letter Source Type: research

Related Links:

An author name was misspelled in the article “Endoscopic intervention and cholecystectomy in pregnant women with acute biliary pancreatitis decrease early readmissions,” published in the June issue of Gastrointestinal Endoscopy (Gastrointest Endosc 2019;89:1169-77). The correct spelling is Jeffery R. Groce, MD.
Source: Gastrointestinal Endoscopy - Category: Gastroenterology Tags: Erratum Source Type: research
Reproductive-aged women constitute a substantial proportion of patients who undergo weight-loss procedures. While the risk of gallstone disease following such procedures has been addressed extensively; the impact of pregnancy on gallstone disease following bariatric procedures has not been reported.
Source: Surgery for Obesity and Related Diseases - Category: Surgery Authors: Tags: Original articles Source Type: research
Reproductive-aged women constitute a substantial proportion of patients who undergo weight loss procedures. While the risk of gallstone disease after such procedures has been addressed extensively, the impact of pregnancy on gallstone disease after bariatric procedures has not been reported.
Source: Surgery for Obesity and Related Diseases - Category: Surgery Authors: Tags: Original article Source Type: research
The benefits of ERCP in the management of acute biliary pancreatitis in pregnancy and its reduction in early readmission is described in this issue by Luthra et  al.1 Using administrative data of the Nationwide Readmission Database (2011-2014), the authors found that pregnant women were less likely to receive ERCP or laparoscopic cholecystectomy in acute biliary pancreatitis (ABP) and had higher 30-day readmission rates compared with nonpregnant women. The se data build on prior work by Othman et al,2 who reported that conservative treatment (without ERCP) of 112 pregnant patients with symptomatic choledocholithi...
Source: Gastrointestinal Endoscopy - Category: Gastroenterology Authors: Tags: Original article Source Type: research
CONCLUSION: Acute biliary pancreatitis related to pregnancy is not limited to pregnant women, and the incidence of these cases was greater than expected. Acute biliary pancreatitis related to pregnancy can be successfully managed with conservative treatment because it usually has a mild to moderate clinical course. However, the surgeon should keep an early cholecystectomy in mind for patients other than those in the first trimester. PMID: 31135938 [PubMed - in process]
Source: Turkish Journal of Trauma and Emergency Surgery : TJTES - Category: Emergency Medicine Authors: Tags: Ulus Travma Acil Cerrahi Derg Source Type: research
Conclusions: Magnesium sulfate is an important adjuvant drug in the practice of anesthesia, with several clinical effects and a low incidence of adverse events when used at recommended doses. Introduction Magnesium is the fourth most common ion in the body, and it participates in several cellular processes, including protein synthesis, neuromuscular function and stability of nucleic acid, as well as regulating other electrolytes such as calcium and sodium. Magnesium acts as a cofactor in protein synthesis, neuromuscular function and stability and the function of nucleic acids. It is a component of adenosine 5-triph...
Source: Frontiers in Pharmacology - Category: Drugs & Pharmacology Source Type: research
ConclusionLap ECBD avoided ionizing radiation for choledocholithiasis during pregnancy, and can combined with LC as an effective minimally invasive procedure for complicated gallstone disease.
Source: International Journal of Surgery Case Reports - Category: Surgery Source Type: research
AbstractCholelithiasis affects approximately 15% of the US population. Rising trends in obesity and metabolic syndrome have contributed to an increase in diagnosis of cholelithiasis. There are several risk factors for cholelithiasis, both modifiable and nonmodifiable. Women are more likely to experience cholelithiasis than are men. Pregnancy, increasing parity, and obesity during pregnancy further increase the risk that a woman will develop cholelithiasis. The classic presentation of persons experiencing cholelithiasis, specifically when gallstones obstruct the common bile duct, is right upper quadrant pain of the abdomen ...
Source: Journal of Midwifery and Women's Health - Category: Midwifery Authors: Tags: Review Source Type: research
DR DAVID T EFRON (Baltimore, MD): Pregnancy clearly adds angst to virtually any superimposed medical urgency. Gallbladder disease is no exception. While not common, when the situation arises, there has been a paucity of good data to guide management. The authors present retrospective evidence that when performed in the postpartum period, patients undergoing cholecystectomy do better than those who have the procedure during the third trimester. This is seen in terms of better composite maternal outcomes including eclampsia, antepartum hemorrhage, and preterm labor.
Source: Journal of the American College of Surgeons - Category: Surgery Tags: Southern surgical association article Source Type: research
This study aimed to present to evaluate the results of two different approaches in the management of acute cholecystitis during pregnancy: immediate surgery and delayed surgery following conservative management. METHODS: In this study, 20 pregnant women who were treated in our clinic for acute cholecystitis between 2010 and 2018 were included in the analysis. Demographic characteristics, parameters related with acute cholecystitis (gallbladder wall thickness, laboratory data), duration of hospitalization, readmission rates, and preterm labor rate were retrospectively evaluated. RESULTS: The median age was 29.5 ye...
Source: Turkish Journal of Trauma and Emergency Surgery : TJTES - Category: Emergency Medicine Authors: Tags: Ulus Travma Acil Cerrahi Derg Source Type: research
More News: Babies | Cholecystectomy | Pregnancy | Study | Surgery | Women