Document Detail


Conservative management of cholelithiasis and its complications in pregnancy is associated with recurrent symptoms and more emergency department visits.
MedLine Citation:
PMID:  22732875     Owner:  NLM     Status:  Publisher    
Abstract/OtherAbstract:
BACKGROUND: Pancreaticobiliary complications of gallstones are common in pregnancy and can result in serious sequelae. Previous studies have shown conflicting results regarding different approaches of treatment. OBJECTIVE: To compare the outcomes of conservative treatment versus operative and endoscopic interventions in the management of complications related to gallstones during pregnancy. DESIGN: Retrospective chart review. SETTING: Tertiary-care referral facility. PATIENTS: A total of 112 patients who had complications related to gallstones during pregnancy. INTERVENTION: Patients were classified into 3 groups: conservative treatment, laparoscopic cholecystectomy (LC), and ERCP. MAIN OUTCOME MEASUREMENTS: We collected demographic data and information regarding treatment complications and pregnancy outcomes. RESULTS: A total of 112 pregnant patients met the inclusion criteria, with a mean age of 25 years. Main clinical presentations were biliary colic (n = 56), biliary pancreatitis (n = 27), acute cholecystitis (n = 17), and choledocholithiasis (n = 12). A total of 68 patients underwent conservative treatment, 13 patients underwent ERCP, 27 patients had LC, and 4 patients received both ERCP and LC. Recurrent biliary symptoms were significantly more common in patients who received conservative treatment (P = .0005). The number of emergency department visits was significantly higher in the conservative treatment group compared with the active intervention group (P = .0006). The number of hospitalizations also was higher in the conservative treatment group (P = .03). Fetal birth weight was similar in both groups (P = .1). Patients treated conservatively were more likely to undergo cesarean section operations for childbirth (P = .04). LIMITATIONS: Single-center, retrospective study. CONCLUSION: Conservative treatment of cholelithiasis and its complications during pregnancy is associated with recurrent biliary symptoms and frequent emergency department visits. ERCP and LC are safe alternative approaches during pregnancy.
Authors:
Mohamed O Othman; Eric Stone; Mariam Hashimi; Gulshan Parasher
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Publication Detail:
Type:  JOURNAL ARTICLE     Date:  2012-6-23
Journal Detail:
Title:  Gastrointestinal endoscopy     Volume:  -     ISSN:  1097-6779     ISO Abbreviation:  -     Publication Date:  2012 Jun 
Date Detail:
Created Date:  2012-6-26     Completed Date:  -     Revised Date:  -    
Medline Journal Info:
Nlm Unique ID:  0010505     Medline TA:  Gastrointest Endosc     Country:  -    
Other Details:
Languages:  ENG     Pagination:  -     Citation Subset:  -    
Copyright Information:
Copyright © 2012 American Society for Gastrointestinal Endoscopy. Published by Mosby, Inc. All rights reserved.
Affiliation:
Division of Gastroenterology, Department of Internal Medicine, Texas Tech University at El Paso, El Paso, Texas.
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