The laparoscopic management of appendicitis and cholelithiasis during pregnancy

BACKGROUND: Laparoscopic management of appendicitis and symptomatic choleli thiasis during pregnancy remains controversial. We report the single larges t series of laparoscopic cholecystectomies and appendectomies during pregna ncy, METHODS: Medical records of all pregnant patients who underwent open or lap aroscopic management of appendicitis/cholelithiasis at LDS Hospital from 19 90 to 1998 were reviewed. RESULTS: Eighteen open appendectomies (OA) and 13 open cholecystectomies (O C) were performed. Forty-five laparoscopic cholecystectomies (LC) and 22 la paroscopic appendectomies (LA) were performed without birth defects, fetal loss or uterine injury. Preterm delivery rates (PTD) in the LA and OA group s were similar (15.8% versus 11.8%, P > 0.9), The PTD rate in the LC group was not significantly different than in the OC group (11.9% versus 10.0%, P > 0.9). Neither birth weights nor Apgar scores were significantly differen t across groups. CONCLUSIONS: Laparoscopic management of appendicitis and symptomatic cholel ithiasis during pregnancy can be performed with minimal fetal and maternal morbidity when accepted management guidelines are followed. Am J Surg. 1999 ; 178:523-529. (C) 1999 by Excerpta Medica, Inc.