Coledocolitiasis en el embarazo. CPRE y esfinterotomía endoscópica transduodenal como tratamiento electivo

SUMMARY Diseases of the biliary tract include the formation of calculus, especially during pregnancy, in predisposed women. Acute cholecystitis during pregnancy often results in surgery, especially if there is an associated pancreatitis, when surgery becomes obligatory. The advances of endoscopic techniques is an effective solution for surgical treatment of biliary disease. It can be used electively for laparoscopic cholecystectomy in cases of cholecystitis, and endoscopic transduodenal sphincterotomy in the case of choledocolithiasis, both having high success rates. We present a case which supports these proposals. In particular, trans-endoscopic sphincterotomy becomes almost obligatory because there is no gall-bladder, and we were aware of the blockage nearest to the outlet of the common biliary duct, shown on the U/scan. Resolution of the clinical picture is complete, biochemical values and scan results progressively return to normal following this treatment. We think that CPRE with associated transduodenal sphincteroplastia is the treatment of choice in cases of calculus in the bile duct, with associated cholangitis and/or pancreatitis.