medigraphic.com
ISSN 1665-2576 (Print)

2026, Number 1-2

<< Back Next >>

Rev Mex Cir Endoscop 2026; 27 (1-2)

Laparoscopic cholecystectomy during pregnancy: evidence from clinical practice

Medina-Muñoz DE, Muñoz-Maldonado GE, Fernández-Treviño JR, Hernández-Guedea MA, Guajardo-Montemayor AM, Treviño-Arizmendi CJ, Ledesma-Orta OA, Burelo-Moreno E, Guerra-Rodríguez JM, Castillo-Herrera LR, Morales-Ramírez R

Language: Spanish
References: 20
Page: 7-12
PDF size: 236.52 Kb.


ABSTRACT

Introduction: acute cholecystitis is the second most common nonobstetric surgical emergency during pregnancy, with an incidence ranging from 1 in 1,500 to 1 in 10,000 pregnancies a year. Non-obstetric surgical emergencies occur in approximately 1 in every 500-700 pregnancies, representing less than 2% of all cases. Objectives: to describe our experience with pregnant patients diagnosed with cholecystolithiasis who underwent laparoscopic cholecystectomy. Material and methods: we conducted a retrospective, observational, descriptive, and cross-sectional study from January 2019 to December 2024, including pregnant patients who underwent laparoscopic cholecystectomy. A total of 60 cases were identifi ed, 14 of which were excluded, leaving 46 for fi nal analysis. We performed a descriptive analysis of the studied variables. Results: we analyzed 46 pregnant patients; most with classic symptoms and cholelithiasis (89%). All underwent laparoscopic cholecystectomy with low intraoperative bleeding and short hospital stays. Signifi cant associations were found between gestational diabetes and membrane rupture, hypertension, and biliary sludge, multiparity and cholelithiasis, normal BMI, and shorter surgical time. Conclusion: in our experience, laparoscopic cholecystectomy in pregnant patients with biliary pathology is a safe procedure. Factors such as multiparity, BMI and gestational history were associated with relevant clinical fi ndings. We consider that since there is no national standardization for the multidisciplinary management of these cases, guidelines based on international evidence are required.


REFERENCES

  1. Nan X, Chan E, Wong KSC, Ng J, Izwan S, Cooper M etal. Laparoscopic cholecystectomy in pregnancy: a sevenyearretrospective study from an Australian tertiary center.Cureus. 2023; 15: e50034. doi: 10.7759/cureus.50034.

  2. Nasioudis D, Tsilimigras D, Economopoulos KP. Laparoscopiccholecystectomy during pregnancy: A systematic review of590 patients. Int J Surg. 2016; 27: 165-175. doi: 10.1016/j.ijsu.2016.01.070.

  3. Balinskaite V, Bottle A, Sodhi V, Rivers A, Bennett PR, BrettSJ et al. The risk of adverse pregnancy outcomes followingnonobstetric surgery during pregnancy: estimates from aretrospective cohort study of 6.5 million pregnancies. AnnSurg. 2017; 266: 260-266.

  4. Rasmussen AS, Christiansen CF, Uldbjerg N, NorgaardM. Appendectomy, cholecystectomy and diagnosticlaparoscopy conducted before pregnancy and risk ofadverse birth outcomes: a nationwide registry-basedprevalence study 1996-2015. BMC Pregnancy Childbirth.2020; 20: 108. doi: 10.1186/s12884-020-2796-3.

  5. Fong ZV, Pitt HA, Strasberg SM, Molina RL, Perez NP,Kelleher CM et al. Cholecystectomy during the thirdtrimester of pregnancy: proceed or delay? J Am Coll Surg.2019; 228: 494-502.e1.

  6. Álvarez-Villaseñor AS, Mascareño-Franco HL, Agundez-Meza JJ et al. Colelitiasis en el embarazo y posparto.Prevalencia, presentación y consecuencias en un hospitalde referencia en Baja California Sur. Gac Med Mex. 2017;153: 159-165.

  7. Chávez-Saavedra G, Lara-Lona E, Díaz-Martínez D,Villaseñor-López-Velarde L, Espinosa-Hinojosa A, Rivera-Sahagún M. Litiasis vesicular durante el embarazo y elpuerperio: ¿estamos haciendo lo correcto en México?. CirCir. 2023; 91: 804-809.

  8. Mora Amoroso EG, Salas Ochoa ES, Yánez VelasteguiÁngel C, Pastor Romero SA. Therapeutic managementof gallbladder disorders in pregnant women. AD. 2023;6: 667-686. Available in: https://doi.org/10.33262/anatomiadigital.v6i4.3.2828

  9. Guzmán BP, Heredia R, Niño de Guzmán O, VerduguezN. Colecistitis aguda en el embarazo. Gac Med Bol.2005; 28: 42-49. Disponible en: http://www.scielo.org .bo/scielo.php?script=sci_arttext&pid=S1012-29662005000200008&lng=es

  10. Amoli HA, Tavakoli H, Notash AY, Far MS, Khashayar P.Laparoscopic cholecystectomy during pregnancy: A caseseries. Journal of Minimal Access Surgery. 2008; 4 (1): 9-14.doi: 10.4103/0972-9941.40991.

  11. Laffita Labañino W. Tratamiento de la enfermedadlitiásica biliar en el embarazo. Rev Cubana ObstetGinecol. 2011; 37: 76-83. Disponible en: http://scielo.sld.cu/scielo.php?script=sci_arttext&pid=S0138-600X2011000100009&lng=es

  12. González Zúñiga AM. Coledocolitiasis en el embarazo.Reporte de caso. Clin Investig Ginecol Obstet. 2019; 46:122-126. doi: 10.1016/j.gine.2019.01.001.

  13. Pinilla Lizarraga R, Romero E, Rojas L, Claros N. Manejode la enfermedad litiasica vesicular sintomática durante elembarazo. Rev Méd La Paz. 2014; 20: 23-29. Disponibleen: http://www.scielo.org .bo/scielo.php?script=sci_arttext&pid=S1726-89582014000200005&lng=es

  14. Pérez Ramírez M, Pérez Ramírez R, Hartmann Guilarte A.Enfermedad litiásica biliar en pacientes embarazadas: EstudioEcográfico. Rev Cubana Obstet Ginecol. 2001; 27: 124-128.Disponible en: http://scielo.sld.cu/scielo.php?script=sci_arttext&pid=S0138-600X2001000200006&lng=es

  15. Llosa Tejada R. Embarazo y litiasis biliar: especial referenciaa la colecistectomía laparascópica. Rev Med Hered. 1996;7: 41-45. Disponible en: http://www.scielo.org.pe/scielo.php?script=sci_arttext&pid=S1018-130X1996000100008&lng=es&tlng=es

  16. Rogers VL, Roberts SW. Colelitiasis, colecistitis y colestasisintrahepática del embarazo. En: Papadakis MA, McPheeSJ, Rabow MW, editores. Diagnóstico clínico y tratamiento2021. Nueva York: McGraw-Hill Education; 2021.

  17. Ibarra-Rovirosa EA, García-Hernández GG, Flores-MendozaJE, Silva-Hernández RJ, Martínez-Hernández CM, Pérez-Alcázar KV. Colecistitis aguda durante el segundo trimestredel embarazo: reporte de un caso. Ginecol Obstet Méx.2022; 90: 520-524. Disponible en: http://www.scielo.org .mx/scielo.php?script=sci_arttext&pid=S0300-90412022000600520&lng=es

  18. Vázquez C, Morán R, Oholeguy P, LabanderaD, González N. Colédocolitiasis y embarazo:presentación de cuatro casos. Arch Med Int. 2010;32: 27-30. Disponible en: http://www.scielo.edu.uy/scielo.php?script=sci_arttext&pid=S1688-423X2010000200002&lng=es

  19. Juárez A, Rivera AM, Alarcón I, Durán MA, Islas LP, TéllezSE. Colecistectomía durante la resolución obstétrica, eventosimultáneo. Clin Investig Ginecol Obstet. 2014; 41: 77-79.doi: 10.1016/j.gine.2010.10.007.

  20. Zeoli M, Pontillo M, Guillén A, Tarigo N, Delgado J,Andreoli G et al. Colecistectomía en embarazadascon patología biliar complicada en el Hospital deClínicas. Cir Urug. 2024; 8: e201. doi: 10.31837/cir.urug/8.1.17.




2020     |     www.medigraphic.com