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Cholecystectomy During the Third Trimester of Pregnancy: Proceed or Delay?

Authors :
Rose L. Molina
Henry A. Pitt
Mark A. Talamini
Jason K. Sicklick
Cassandra M. Kelleher
David C. Chang
Numa P. Perez
Keith D. Lillemoe
Andrew P. Loehrer
Zhi Ven Fong
Steven M. Strasberg
Source :
Journal of the American College of Surgeons. 228:494-502e1
Publication Year :
2019
Publisher :
Ovid Technologies (Wolters Kluwer Health), 2019.

Abstract

Background Current guidelines suggest that cholecystectomy during the third trimester of pregnancy is safe for both the woman and the fetus. However, no population-based study has examined this issue. The aim of this analysis was to compare the results of cholecystectomy during the third trimester of pregnancy with outcomes in women operated on in the early postpartum period in a large population. Methods The California Office of Statewide Health Planning and Development database was queried from 2005 to 2014. Women undergoing cholecystectomy during the third trimester of pregnancy (n = 403) were compared with those having this procedure in the 3 months post partum (n = 17,490). Patient demographics as well as maternal delivery and cholecystectomy-related outcomes were compared by standard statistics as well as after adjustments for age, race, comorbidities, insurance status, and hospital setting. Results Women who underwent cholecystectomy during the third trimester were older (27 vs 25 years; p Conclusions Maternal delivery and procedure-related outcomes were worse when cholecystectomy was performed during the third trimester of pregnancy. Preterm delivery, which is associated with multiple adverse infant outcomes, was increased in third-trimester women. Whenever possible, cholecystectomy should be delayed until the postpartum period.

Details

ISSN :
10727515
Volume :
228
Database :
OpenAIRE
Journal :
Journal of the American College of Surgeons
Accession number :
edsair.doi...........ce6977240254daae8b08534b3ee789e9