Document Detail


Endoscopic sphincterotomy for the treatment of gallstone pancreatitis during pregnancy.
MedLine Citation:
PMID:  9569356     Owner:  NLM     Status:  MEDLINE    
Abstract/OtherAbstract:
BACKGROUND: Gallstones are the most common cause of acute pancreatitis during pregnancy. Without intervention, gallstone pancreatitis during pregnancy is associated with an antepartum recurrence rate of 70%, which exposes the mother and fetus to an increased risk of morbidity and mortality. A safe, effective means to prevent recurrent gallstone pancreatitis during pregnancy is desirable. METHODS: Since 1991, we have managed gallstone pancreatitis in three pregnant patients with endoscopic retrograde cholangiogram (ERC), followed by spincterotomy, despite the absence of common bile duct stones. RESULTS: All patients were judged to have mild pancreatitis by modified Ranson criteria and the Multiorgan System Failure criteria. During cholangiogram, fetal shielding was employed and fluoroscopy times ranged from 36 s to 7.2 min. One patient experienced postprocedure pancreatitis of 48-h duration. None of the patients experienced further episodes of pancreatitis and none underwent predelivery cholecystectomy. CONCLUSIONS: In pregnancy-associated gallstone pancreatitis, endoscopic sphincterotomy prevents recurrence of pancreatitis and the need for cholecystectomy during gestation. We believe endoscopic sphincterotomy represents a promising management alternative for gallstone pancreatitis during pregnancy. Further investigation is warranted.
Authors:
J S Barthel; T Chowdhury; B W Miedema
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Publication Detail:
Type:  Case Reports; Journal Article    
Journal Detail:
Title:  Surgical endoscopy     Volume:  12     ISSN:  0930-2794     ISO Abbreviation:  Surg Endosc     Publication Date:  1998 May 
Date Detail:
Created Date:  1998-05-21     Completed Date:  1998-05-21     Revised Date:  2004-11-17    
Medline Journal Info:
Nlm Unique ID:  8806653     Medline TA:  Surg Endosc     Country:  GERMANY    
Other Details:
Languages:  eng     Pagination:  394-9     Citation Subset:  IM    
Affiliation:
Division of Gastroenterology, Department of Medicine, MA-421, University of Missouri School of Medicine, Columbia, MO 65212, USA.
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MeSH Terms
Descriptor/Qualifier:
Adolescent
Adult
Cholangiopancreatography, Endoscopic Retrograde
Cholelithiasis / complications,  radiography,  surgery*
Female
Humans
Pancreatitis / etiology,  radiography,  surgery*
Pregnancy
Pregnancy Complications / surgery*
Sphincterotomy, Endoscopic*
Comments/Corrections
Comment In:
Surg Endosc. 1998 May;12(5):387-9   [PMID:  9569354 ]

From MEDLINE®/PubMed®, a database of the U.S. National Library of Medicine


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