N. Allmendinger et al., PERCUTANEOUS CHOLECYSTOSTOMY TREATMENT OF ACUTE CHOLECYSTITIS IN PREGNANCY, Obstetrics and gynecology, 86(4), 1995, pp. 653-654
Background: Medical treatment of acute cholecystitis in pregnancy may
lead to prolonged management and recurrent hospitalizations, whereas s
urgical management predisposes the mother and fetus to the inherent ri
sks of surgery and general anesthesia. Although percutaneous cholecyst
ostomy has been proven to be an efficacious treatment in critically il
l and general surgery patients who are at high risk for surgery, this
technique has not been used routinely as a treatment for acute cholecy
stitis in pregnancy. Cases: We report two women (at 30 and 32 weeks' g
estation, respectively) who presented with acute calculus cholecystiti
s. The first patient was a 33-year-old female who failed endoscopic re
trograde cholangiopancreatography and papillotomy and had multiple ret
urn visits for nausea and vomiting. The second patient was a 23-year-o
ld female with three previous admissions for cholecystitis during the
pregnancy. These two patients underwent emergency ultrasound-guided pe
rcutaneous transhepatic cholecystostomy. Percutaneous cholecystostomy
provided adequate biliary decompression for the remainder of the pregn
ancy; the patients delivered healthy infants and underwent successful
uncomplicated elective laparoscopic cholecystectomy within 3 months of
delivery. Conclusion: Percutaneous cholecystostomy may provide a safe
and effective alternative for the palliation of acute cholecystitis i
n pregnancy until a postpartum cholecystectomy can be performed.