THE EFFICIENCY OF LAPAROSCOPIC SURGERY FOR WOMEN HOSPITALIZED WITH ACUTE CHOLECYSTITIS AT DIFFERENT STAGES OF PREGNANCY.

Main Article Content

Allah Bachayo Rajar
Imam Bakhsh
Abdul Rehman
Shah Nawaz Khatti
Abdul Rahim
Imtiaz Ali Langah

Keywords

complicated gallstones, pregnant women, fetal and maternal problems, endoscopic retrograde cholangiopancreatography

Abstract

Background: Gallstones are detected in 1–3% of pregnancies, and 0.05–8% of cases result in biliary disease symptoms. It is thought that progesterone and estrogen cause bile to have higher amounts of cholesterol, which can contribute to the formation of gallstones during pregnancy. Acute appendicitis is the most common cause of non-obstetric abdominal surgical complications during pregnancy, with acute cholecystitis coming in second. Choosing conservative therapies carries hazards for the fetus as well as the mother. Approximately 27–36% of people with symptomatic biliary illness may still need surgery after receiving medical care.


Objective: To evaluate the efficiency of laparoscopic surgery for women hospitalized with acute cholecystitis at different stages of pregnancy.


Study design: An analytical cross-sectional study


Place and Duration:  This study was conducted in Muhammad Medical and Dental College Mirpurkhas from September 2022 to September 2023.


Methodology: A total of 30 women were included in this research. All of the participants were pregnant women diagnosed with acute cholecystitis. The gathered data included demographics, gestational age, symptoms, clinical and physical examination, maternal and fetal complications, radiological findings, number of pregnancies, treatment, diagnosis, frequency of hospital admissions, and time period of stay in hospital. Some of the things that were looked into before and during surgery were the abdominal entrance technique and the use of endoscopic retrograde cholangiopancreatography (ERCP).


Results: A total of 30 pregnant women were involved in this research. All of these participants had complicated gallstone diseases like cholangitis, choledocholithiasis, and acute cholecystitis. The patients were divided into two groups. Group A was the immediate surgery group, which included a total of 9 patients. Group B was the conservative management and delayed surgery group, which included a total of 21 patients. The participant’s mean age was 29.5 years. The mean gestational period at the time of diagnosis was 20 weeks.


Conclusion: Managing complicated gallstone diseases during pregnancy presents a difficult problem because of the increased rates of fetal and maternal problems.

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