gall stone
| Discussion in 'All Categories' started by jini - Mar 3rd, 2012 6:07 am. | |
jini
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i have multiple gall stone ,blocking common bile duct on and often and i am 12 week prgnant. the surgeon suggesting lap chole during second trimester. will it harm the foetus? |
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re: gall stone
by Dr M K Gupta -
Mar 3rd, 2012
9:23 pm
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Dr M K Gupta
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Dear Jini Previously non-operative management of symptomatic cholelithiasis in pregnancy has been recommended. At present early surgical management may be the treatment of choice. Early surgical management of gravid patients with symptomatic gallstones is supported by data showing recurrent symptoms in 92% of patients managed non-operatively who contained in the first trimester, 64% who present in the 2nd trimester, and 44% who contained in the 3rd trimester. This delay in surgical management results in increased rates of hospitalizations, spontaneous abortions, preterm labor, and preterm delivery than others undergoing cholecystectomy. Altogether, nonoperative control over symptomatic gallstones in gravid patients results in recurrent symptoms in additional than 50% of patients, and 23% of such patients develop acute cholecystitis or gallstone pancreatitis. Gallstone pancreatitis results in fetal reduction in 10% to 60% of pregnant patients. The functional morbidity and mortality associated with untreated gallbladder disease within the gravid patient favor surgical treatment. Laparoscopic cholecystectomy is preferred because of the salutary outcomes and favorable side-effect profile. There happen to be no reports of fetal demise for laparoscopic cholecystectomy performed throughout the first and second trimesters. Furthermore, decreased rates of spontaneous abortion and preterm labor happen to be reported in laparoscopic cholecystectomy when compared to laparotomy. So in our opinion you should get the surgery done in second trimester. With regards M.K. Gupta |