Our Summary

This research article is a review and analysis of multiple studies to compare two methods of gallbladder surgery during pregnancy: laparoscopic cholecystectomy (LC), which uses a camera and small incisions, and open cholecystectomy (OC), which involves a larger incision. The review included 11 studies with over 10,000 patients. The data showed that LC was generally safer for both the mother and baby, causing fewer complications. In fact, the odds of complications during LC were less than half of those during OC. Mothers who had LC also spent less time in the hospital after surgery. However, the study mentions that most of the patients analyzed were in early stages of pregnancy, so the results may not apply to later stages of pregnancy. Despite this, the research suggests that LC is a better option for removing gallstones during the first two trimesters of pregnancy.

FAQs

  1. What are the two methods of gallbladder surgery during pregnancy discussed in the article?
  2. Based on the review of multiple studies, which method appears to be safer for both the mother and baby?
  3. Does the research suggest that laparoscopic cholecystectomy is a better option for all stages of pregnancy or only specific trimesters?

Doctor’s Tip

One helpful tip a doctor might give a patient about cholecystectomy is to discuss the possibility of undergoing a laparoscopic cholecystectomy (LC) during pregnancy, as it has been shown to be safer for both the mother and baby compared to open cholecystectomy (OC). Make sure to consult with your healthcare provider to determine the best course of action for your individual situation.

Suitable For

Patients who are typically recommended cholecystectomy include those who have:

  1. Symptomatic gallstones causing pain, inflammation, infection, or blockage of the bile ducts.
  2. Chronic gallbladder inflammation (cholecystitis) that does not respond to conservative treatment.
  3. Gallbladder polyps or tumors.
  4. Complications such as pancreatitis or jaundice due to gallstones.
  5. Patients with a history of recurrent gallstone attacks.
  6. Patients who are at high risk for developing complications from gallstones, such as those with diabetes or a weakened immune system.

Timeline

Before Cholecystectomy:

  1. Patient experiences symptoms of gallbladder issues such as pain in the upper right abdomen, nausea, vomiting, and bloating.
  2. Patient undergoes diagnostic tests such as ultrasound or CT scan to confirm the presence of gallstones.
  3. Patient may be prescribed medications to manage symptoms or advised to follow a specific diet.
  4. Patient discusses surgical options with their healthcare provider and decides to undergo cholecystectomy.

After Cholecystectomy:

  1. Patient undergoes pre-operative evaluations and tests to ensure they are fit for surgery.
  2. Cholecystectomy is performed either through laparoscopic or open surgery.
  3. Post-operative care includes pain management, monitoring for complications, and gradually resuming normal activities.
  4. Patient may experience temporary side effects such as pain, bloating, and changes in bowel habits.
  5. Patient is advised on dietary changes to prevent gallstone formation in the future.
  6. Patient follows up with their healthcare provider for monitoring and follow-up care.

What to Ask Your Doctor

  1. What are the risks and benefits of both laparoscopic cholecystectomy and open cholecystectomy during pregnancy?
  2. How will the surgery impact my pregnancy and the health of my baby?
  3. What is the recovery process like for each type of surgery?
  4. Will I need to make any changes to my prenatal care or delivery plans after the surgery?
  5. Are there any specific considerations I should keep in mind during the surgery and recovery period?
  6. How experienced are you in performing cholecystectomy surgeries on pregnant patients?
  7. What is the likelihood of complications during and after the surgery?
  8. Are there any alternative treatment options that do not involve surgery?
  9. How soon after the surgery can I resume normal activities and exercise?
  10. Will I need any follow-up care or monitoring after the surgery?

Reference

Authors: Sedaghat N, Cao AM, Eslick GD, Cox MR. Journal: Surg Endosc. 2017 Feb;31(2):673-679. doi: 10.1007/s00464-016-5019-2. Epub 2016 Jun 20. PMID: 27324332