Management of Symptomatic Gallstones in Pregnancy: Gallstone Management in Pregnancy

Zahoor Hussain; Zulfiqar Ali; . Sirajudin; Abu Baker; . Sadaf; Aijaz Hussain

doi:10.54393/pjhs.v5i09.2101

Authors

Zahoor Hussain Department of Surgery, Khairpur Medical College, Khairpur, Pakistan
Zulfiqar Ali Department of Anatomy, Khairpur Medical College, Khairpur, Pakistan
. Sirajudin Department of Surgery, Pir Abdul Qadir Shah Jeelani Institute of Medical Sciences, Gambat Institute of Medical Sciences, Gambat, Pakistan
Abu Baker Department of Surgery, Khairpur Medical College, Khairpur, Pakistan
. Sadaf Department of Surgery, Khairpur Medical College, Khairpur, Pakistan
Aijaz Hussain Department of Urology, Peoples University of Medical and Health Sciences, Nawabshah, Pakistan

DOI:

https://doi.org/10.54393/pjhs.v5i09.2101

Keywords:

Gallstones, Pregnancy, Laparoscopic Cholecystectomy, Cholelithiasis

Abstract

Gallstones, also known as cholelithiasis, are crystalline forms that occur in the gallbladder or biliary tract. Pregnancy causes various physiological changes that raise the chance of gallstone formation, which can lead to difficulties for both the mother and the fetus. Objective: To examine the safety and outcomes of conventional and interventional treatment in pregnant women with symptomatic gallstones. Methods: The study was longitudinal study. This study was conducted in Khairpur Medical College Civil Hospital Khairpur Mirs. The duration of this study was one Year, from Jan 2023 to Dec 2023. A total number of participant was (N=250) in this study. The age of participants was 18-35 years. There were included two treatment conventional and interventional. Results: The mean age of patients was 35.5 years. This study included 250 patients, had experienced gallstone symptoms. The intervention treatment group had the most participants (76%), followed by the conservative treatment group (24%). The cholecystitis participants had conservative treatment (76.3%), followed by laparoscopic treatment (53.3%). The majority participants was (66.6%) got laparoscopic therapy in the second trimester and indicate significant outcomes as compared to third trimester. The pregnant women was experienced no mortality, miscarriage during intervention therapy. Conclusions: This study supported prior findings that laparoscopic cholecystectomy can be performed safely during pregnancy, particularly in the second trimester. However, the third trimester brings additional obstacles, as seen by the higher prevalence of open cholecystectomy.

References

Oktamovich AU. Gallstones in Pregnant Women: Detection, Obstacles, and Treatment. Новости образования: исследование в XXI веке. 2023 Dec; 2(16): 31-8.

Atanasiu IE, Gheoca GD, Botezatu R, Ciobanu AM, Gica C, Cimpoca-Raptis BA et al. Acute cholecystitis in pregnancy. Romanian Medical Journal. 2022 Apr; 69(2): 13. doi: 10.37897/RMJ.2022.S2.3. DOI: https://doi.org/10.37897/RMJ.2022.S2.3

Bowie JM, Calvo RY, Bansal V, Wessels LE, Butler WJ, Sise CB et al. Association of complicated gallstone disease in pregnancy and adverse birth outcomes. The American Journal of Surgery. 2020 Sep; 220(3): 745-50. doi: 10.1016/j.amjsurg.2020.01.038. DOI: https://doi.org/10.1016/j.amjsurg.2020.01.038

Sultan AI, Saadi RK, Habash MM, Ghareeb OA. Outcomes of symptomatic gallstone disease in pregnant women: A retrospective study. Journal of Population Therapeutics and Clinical Pharmacology. 2023 Feb; 30(2): 1-7. doi: 10.47750/jptcp.2023.1055. DOI: https://doi.org/10.47750/jptcp.2023.1055

Brown KE, Hirshberg JS, Conner SN. Gallbladder and biliary disease in pregnancy. Clinical Obstetrics and Gynecology. 2020 Mar; 63(1): 211-25. doi: 10.1097/GRF.0000000000000496. DOI: https://doi.org/10.1097/GRF.0000000000000496

Hess EC, Thumbadoo RP, Thorne EP, McNamee K. Gallstones in pregnancy. British Journal of Hospital Medicine. 2021 Feb; 82(2): 18-25. doi: 10.12968/hmed.2020.0330. DOI: https://doi.org/10.12968/hmed.2020.0330

Gutt C, Schläfer S, Lammert F. The treatment of gallstone disease. Deutsches Ärzteblatt International. 2020 Feb; 117(9): 148. doi: 10.3238/arztebl.2020.0148. DOI: https://doi.org/10.3238/arztebl.2020.0148

Schwulst SJ and Son M. Management of gallstone disease during pregnancy. Journal of the American Medical Association Surgery. 2020 Dec; 155(12): 1162-3. doi: 10.1001/jamasurg.2020.3683.

Weinstein MS, Feuerwerker S, Baxter JK. Appendicitis and cholecystitis in pregnancy. Clinical Obstetrics and Gynecology. 2020 Jun; 63(2): 405-15. doi: 10.1097/GRF.0000000000000529. DOI: https://doi.org/10.1097/GRF.0000000000000529

Belal S, Hamed HM, Kamal A, Al-Sayed MA, Abd El Hamid HM. Risk Factors Associated with Cholelithiasis during Pregnancy and Postpartum. Open Journal of Obstetrics and Gynecology. 2022 Nov; 12(11): 1166-75. doi: 10.4236/ojog.2022.1211101. DOI: https://doi.org/10.4236/ojog.2022.1211101

Sundaram KM, Morgan MA, Depetris J, Arif-Tiwari H. Imaging of benign gallbladder and biliary pathologies in pregnancy. Abdominal Radiology. 2023 Jun; 48(6): 1921-32. doi: 10.1007/s00261-023-03832-1. DOI: https://doi.org/10.1007/s00261-023-03832-1

Alsadery HA, Bamalan OA, Aljubran HJ, Albaish LJ, Al Ghanim BZ. Non-obstetric acute abdomen in pregnancy: a review of literature. Medical Archives. 2023; 77(4): 293. doi: 10.5455/medarh.2023.77.293-298. DOI: https://doi.org/10.5455/medarh.2023.77.293-298

Handaya AY, Fauzi AR, Andrew J, Hanif AS, Radinal K, Aditya AF. Management of gallstone-induced severe acute cholecystitis and pancreatitis in the second trimester of pregnancy during covid-19 pandemic: A case report. Annals of Medicine and Surgery. 2021 Aug; 68: 102563. doi: 10.1016/j.amsu.2021.102563. DOI: https://doi.org/10.1016/j.amsu.2021.102563

Bass RB and Teitelbaum EN. Novel advances in surgery for Gallstone Disease. Current Gastroenterology Reports. 2022 Jul; 24(7): 89-98. doi: 10.1007/s11894-022-00844-7. DOI: https://doi.org/10.1007/s11894-022-00844-7

Salari N, Hasheminezhad R, Heidarisharaf P, Khaleghi AA, Azizi AH, Shohaimi S et al. The global prevalence of gallstones in pregnancy: A systematic review and meta-analysis. European Journal of Obstetrics & Gynecology and Reproductive Biology: X. 2023 Sep; 19: 100237. doi: 10.1016/j.eurox.2023.100237. DOI: https://doi.org/10.1016/j.eurox.2023.100237

Moreno CC, Mittal PK, Miller FH. Nonfetal imaging during pregnancy: acute abdomen/pelvis. Radiologic Clinics. 2020 Mar; 58(2): 363-80. doi: 10.1016/j.rcl.2019.10.005. DOI: https://doi.org/10.1016/j.rcl.2019.10.005

Schwulst SJ and Son M. Management of gallstone disease during pregnancy. JAMA surgery. 2020 Dec; 155(12): 1162-3. doi: 10.1001/jamasurg.2020.3683. DOI: https://doi.org/10.1001/jamasurg.2020.3683

Conti-Ramsden F, McEwan M, Hill R, Wade J, Abraham G, Buckeldee O et al. Detection of additional abnormalities or co-morbidities in women with suspected intrahepatic cholestasis of pregnancy. Obstetric Medicine. 2020 Dec; 13(4): 185-91. doi: 10.1177/1753495X19868873. DOI: https://doi.org/10.1177/1753495X19868873

Abeysuriya V, Dodampahala SH, Chandrasena L. Prevalence and some selected characteristics of asymptomatic gallstones among pregnant women. A Retrospective Chart Review. 2022 Nov; 44(3): 153-158. doi: 10.4038/sljog.v44i3.8063. DOI: https://doi.org/10.4038/sljog.v44i3.8063

Picardo E, Tota D, Gemmiti S, Danese S, Benedetto C, Mitidieri M. Acute pancreatitis in pregnancy: Are gallstones and Gilbert's syndrome cofactors?. European Journal of Obstetrics and Gynecology and Reproductive Biology. 2021 Aug; 263: 281-2. doi: 10.1016/j.ejogrb.2021.05.012. DOI: https://doi.org/10.1016/j.ejogrb.2021.05.012

Song ST, Shi J, Wang XH, Guo YB, Hu PF, Zhu F et al. Prevalence and risk factors for gallstone disease: a population‐based cross‐sectional study. Journal of Digestive Diseases. 2020 Apr; 21(4): 237-45. doi: 10.1111/1751-2980.12857. DOI: https://doi.org/10.1111/1751-2980.12857