Laparoscopic cholecystectomy during pregnancy: A case series

Abstract Objective To study safety, feasibility and short term outcomes of laparoscopic cholecystectomy during pregnancy. Methods Between January 2013 to December 2016, all patients undergoing laparoscopic cholecystectomy during pregnancy at our hospital were retrospectively identified. Eight patients underwent laparoscopic cholecystectomy for symptomatic biliary disease during first and second trimester of pregnancy. Laparoscopic cholecystectomy was performed under general anesthesia. Results During the study period of 4 years from January 2013 to December 2016, 8 patients with gestational ages ranging from 11 to 28 weeks underwent laparoscopic cholecystectomy during pregnancy. Of them 2 patients were in the first trimester and 6 patients in the second trimester. The indication for surgical intervention was unrelenting biliary colic unresponsive to medical management and cholecystitis in 7 patients and gangrenous gall bladder in one patient. The latter patient had undergone successful Endoscopic Retrograde Cholangio Pancreatography (ERCP) followed by laparoscopic cholecystectomy after 5 days. There were no conversions to open. All patients had an uneventful post-operative recovery. There were no miscarriage or premature births in this group. There was one fetal demise 5 weeks following surgery due to severe oligoamnios, incidence of which is unrelated to laparoscopy. Conclusion Laparoscopic cholecystectomy during pregnancy is safe for both the mother and the unborn fetus. Surgery is indicated in unrelenting biliary colic or complications of cholelithiasis. Extreme caution during access to the abdominal cavity and keeping pneumoperitoneum pressures and operating times to a minimum should be kept in mind at all times.