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Indian Journal of Surgery, Vol. 67, No. 4, July-August, 2005, pp. 225 Letter To Editor Laparoscopic cholecystectomy during pregnancy Dalmia S, Dalmia R Royal Shrewsbury Hospital, Shrewsbury Code Number: is05071 Dear Editor, I read the article by Singh with interest.[1] He has nicely presented a series of 20 patients who underwent laparoscopic cholecystectomy in second and third Trimester of Pregnancy. I agree there is good evidence in literature of successful laparoscopic cholecystectomy in pregnancy. However I just want to emphasize that gall stone disease treatment in pregnancy is same as in nonpregnant patients. Conservative treatment is the first line of treatment and if surgery is required laparoscopic cholecystectomy can be done safely with precautions as mentioned by Singh et al. While there is increasing trend towards laparoscopic cholecystectomy in acute cholecystitis it should not be the case during pregnancy without conservative treatment. Muench has shown that delay in laparoscopic cholecystectomy in-patient with recurrent symptoms has higher incidence of premature delivery. Nonrandomized studies have shown that laparoscopic cholecystectomy is preferred method of treatment over open cholecystectomy in pregnancy.[2] Second trimester of pregnancy is the preferred time as foetal organogenesis is complete and uterus is still not very large. No significant differences in preterm delivery rates, birth weights, or 5-min Apgar scores were found between open or laparoscopic cholecystectomy. No birth defects or uterine injuries occurred.[3][4] References
Copyright 2005 - Indian Journal of Surgery |
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