PERCUTANEOUS CHOLECYSTOSTOMY TREATMENT OF ACUTE CHOLECYSTITIS IN PREGNANCY

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.