Ávila-Silva MR, Zavala-Castillo JC, Coronel-Cruz FM

Language: Spanish
References: 10
Page: 509-517
PDF size: 394.42 Kb.

ABSTRACT

Background: Cholecystitis is the second cause of abdominal pain during pregnancy. 1-8 of 10,000 requiring surgery, being performed in the first and second quarter laparoscopically. 100% of patients with cholecystitis, about 12% are associated with pancreatitis with high rates of maternal and fetal morbidity and mortality.
Objective: To evaluate advantages - disadvantages of maternal-fetal pregnancy laparoscopic cholecystectomy and its preventive character avoiding cases of pancreatitis. We analyze the results obtained in Perinatology Service in General Hospital of Mexico ( 2008 to 2012 ) comparing them with the current literature.
Material and methods: A retrospective, cross sectional, descriptive. Analyzing the following variables: maternal age, gestational age, number of gestations, surgical technique, and postoperative complications trans, maternal and perinatal morbidity, gallbladder colic episodes prior, liver ultrasound report - bile ducts, tocolytic management.
Results: 20 laparoscopic cholecystectomies were performed in pregnant patients. Maternal age 21-38 years, mostly multigesta. 5 patients was performed at weeks 9, 14, 20 and 25 between the SDG and 1 at 27.5 SDG. Vesicular colicky eight previous USG mostly with gallstones. Two cases of mild acute pancreatitis satisfactorily resolved. No trans or postoperative complications. Open technique for performing pneumoperitoneum (Hasson). Tocolytic management indomethacin in 100% of cases.
Conclusions: The results obtained are consistent with the current literature, confirming that laparoscopic cholecystectomy is the best treatment option with minimal fetal maternal morbidity, reducing the incidence of pancreatitis and maternal- fetal consequences.

REFERENCES

1. Guzmán B., Prudencio, Heredia, Rodrigo, Nino De Guzmán, Oscar Et Al. Colecistitis Aguda En El Embarazo. Gac Med Bol 2005;28:42-49. ISSN 1012-2966.

2. Weber SA, Garteiz Md, Nestel Ir, Núñez Ve. Análisis del papel creciente de la laparoscopia en el manejo del abdomen agudo durante el embarazo. Ginecol Obstet Mex 2001; 69:422-430

3. Demetrius E.M. Litwin, Md, Mitchell A. Cahan. Laparoscopic Cholecystectomy, Surg Clin N Am 88 (2008) 1295–1313. El Sevier Saunders

4. Calleja, Ana. Resultados perinatales de la pancreatitis aguda y embarazo en el Hospital General De Mexico O.D. Del Periodo De Julio 2005 A Julio 2010. Tesis Para Obtener Titulo De Ginecologia Y Obstetricia. Pp 31. 2010

5. Ledesma- Heyer JP. Arias J. Pancreatitis aguda. Med Int Mex 2009; 25, N, 4, Pp 285-94

6. Hernández A, Aguirre X, Pedraza A. Colecistectomía laparoscópica en el embarazo. Experiencia de cinco años en el Hospital Español de México y revisión de la bibliografía, Ginecol Obstet Mex 2011;79(4):200-205

7. Páez-Serralde F. Manejo anestésico en cirugía laparoscópica en paciente obstétrica. Anestesiología en Ginecoobstetricia 2011;34:5108-5111.

8. Society of American Gastrointestinal Endoscopic Surgeons (Sages). Guidelines for Laparoscopic Surgery during Pregnancy. Surg Endosc 1998;12:189-190.

9. Pearl J, Price R, Richardson W, Fanelli R; Society of American Gastrointestinal Endoscopic Surgeons. Guidelines for Diagnosis, Treatment, and Use of Laparoscopy for 11.- 11.- Surgical Problems During Pregnancy. Surg Endosc 2011;25:3479-92. Epub 2011 Sep 23

10. Stany M, Elkas J. Laparoscopic Surgery In Pregnancy Topic 6812 Version 8.0 • All Rights Reserved. 2012 Uptodate