Abstract
Objective: To determining the diagnostic and surgical outcomes in the patients with gallstones treated with laparoscopic cholecystectomy techniques during pregnancy.
Methodology: This descriptive case series study was conducted at the Department of Surgery of Liaquat University of Medical & Health Sciences, Jamshoro. Study duration was one year from July 2019 to June 2020. Inducing the usual anesthesia, veress needle method was used for establishing a pneumoperitoneum. The needle was injected in the right upper abdominal quadrant ahead of the uterine fundus along with 5 mm trocar and a 5 mm laparoscope was passed through this channel. Two trocars of 10 mm size were introduced for direct vision in the Trendelenburg reverse position. The gallbladder dissection was performed using scissors which were associated with electrocautery for instantaneous hemostasis. The exploration of common bile duct was performed through the cystic duct. All the data was collected via study proforma.
Results: Total 30 pregnant patients underwent laparoscopic cholecystectomy, their mean age was 34.23+23.5 years and mean gestational age was 28.12+5.22 weeks. 20 patients became highly symptomatic after eating food which impelled surgical intercession, six patients reported biliary pancreatitis and four had acute cholecystitis. The average time duration of surgical procedure was 60 minutes. All patients except two females who remained pregnant at 16 and 32 gestational weeks have delivered healthy babies with zero developmental abnormalities evidences up to the present time. Nineteen patients were discharged on postoperative 1st day, three on 2nd day, three on 3rd day, and one on 4th day. The patients with biliary pancreatitis or acute cholecystitis were extended their stays in hospital.
Conclusion: All patients were well tolerated the surgical operations with zero labor precipitation or death of fetus only in two patient’s minor superficial infection has been observed. The only utter contraindications would be the unqualified lack of spaces for manipulating the instruments, unclear anatomy during procedure and lack of satisfactory training and experienced surgeons.
Zubair Ahmad Yousfani, Jabeen Atta, Ghullamullah Rind, Champa Sushel, Moomal Zoya, Khenpal Das. (2020) Surgical Outcome in Laparoscopic Cholecystectomy in Pregnant Patients, Journal of the Society of Obstetrics and Gynaecologists of Pakistan , Volume-10, Issue-3.
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