caa a22 4500 475780035 CHVBK 20180406123641.0 cr unu---uuuuu 170329e20000301xx s 000 0 eng 10.1007/s004640000037 doi (NATIONALLICENCE)springer-10.1007/s004640000037 Laparoscopic cholecystectomy and interventional endoscopy for gallstone complications during pregnancy [Elektronische Daten] [P. Sungler, P. M. Heinerman, H. Steiner, H. W. Waclawiczek, J. Holzinger, F. Mayer, A. Heuberger, O. Boeckl] Background: Symptomatic or complicated gallstone disease is the most common reason for nongynecological operations during pregnancy. Gallstones are present in 12% of all pregnancies, and more than one-third of patients fail medical treatment and therefore require surgical endoscopy or laparoscopy. Gallstone pancreatitis and jaundice during pregnancy is associated with a high recurrence rate, exposing both fetus and mother to an increased risk of morbidity and mortality. Methods: During a 4-year period, all pregnant patients (n= 37) with symptomatic or complicated gallstone disease were studied prospectively at the Landeskrankenhaus in Salzburg, Austria. Five patients had an endoscopic retrograde cholangiopancreatogram (ERCP) for biliary pancreatitis or jaundice; two of these underwent subsequent laparoscopic cholecystectomy. Another seven patients required laparoscopic cholecystectomy for severe pain or cholecystitis; all were in their 13th-32nd gestational week. Access was established by Veress needle in all cases. Insufflation pressure was 8-10 mmHg, and mean operative time was 62 min. Results: All patients delivered full-term, healthy babies. There were no postendoscopic or postoperative complications. All patients enjoyed full relief from their symptoms; there were no recurrences of pancreatitis or jaundice. Conclusions: The combination of ERCP and laparoscopic cholecystectomy offers a safe and effective option for the definitive treatment of complicated gallstone disease and intractable pain during pregnancy, and there is sufficient access for the combined treatment to be employed. Springer-Verlag New York Inc., 2000 Key words: Biliary disease — Cholecystectomy — ERCP — Gallbladder — Laparoscopy — Pancreatitis — Pregnancy nationallicence Sungler P. I. Chirurgische Abteilung und Ludwig-Boltzmann-Institut für experimentelle und gastroenterologische Chirurgie, Landeskliniken Salzburg, Müllner Hauptstraße 48, 5020 Salzburg, Austria, Austria aut Heinerman P. M. Sonderauftrag für interventionelle und Laserendoskopie, Landeskliniken Salzburg, Müllner Hauptstraße 48, 5020 Salzburg, Austria, Austria aut Steiner H. Frauenklinik, Landeskliniken Salzburg, Müllner Hauptstraße 48, 5020 Salzburg, Austria, Austria aut Waclawiczek H. W. I. Chirurgische Abteilung und Ludwig-Boltzmann-Institut für experimentelle und gastroenterologische Chirurgie, Landeskliniken Salzburg, Müllner Hauptstraße 48, 5020 Salzburg, Austria, Austria aut Holzinger J. I. Chirurgische Abteilung und Ludwig-Boltzmann-Institut für experimentelle und gastroenterologische Chirurgie, Landeskliniken Salzburg, Müllner Hauptstraße 48, 5020 Salzburg, Austria, Austria aut Mayer F. I. Chirurgische Abteilung und Ludwig-Boltzmann-Institut für experimentelle und gastroenterologische Chirurgie, Landeskliniken Salzburg, Müllner Hauptstraße 48, 5020 Salzburg, Austria, Austria aut Heuberger A. II. Chirurgische Abteilung, Landeskliniken Salzburg, A-5020 Salzburg, Austria, Austria aut Boeckl O. I. Chirurgische Abteilung und Ludwig-Boltzmann-Institut für experimentelle und gastroenterologische Chirurgie, Landeskliniken Salzburg, Müllner Hauptstraße 48, 5020 Salzburg, Austria, Austria aut Surgical Endoscopy Springer-Verlag 14/3(2000-03-01), 267-271 0930-2794 14:3<267 2000 14 464 https://doi.org/10.1007/s004640000037 text/html Onlinezugriff via DOI 1 research-article jats NATIONALLICENCE 856 40 https://doi.org/10.1007/s004640000037 text/html Onlinezugriff via DOI NATIONALLICENCE 700 1- Sungler P. I. Chirurgische Abteilung und Ludwig-Boltzmann-Institut für experimentelle und gastroenterologische Chirurgie, Landeskliniken Salzburg, Müllner Hauptstraße 48, 5020 Salzburg, Austria, Austria aut NATIONALLICENCE 700 1- Heinerman P. M. Sonderauftrag für interventionelle und Laserendoskopie, Landeskliniken Salzburg, Müllner Hauptstraße 48, 5020 Salzburg, Austria, Austria aut NATIONALLICENCE 700 1- Steiner H. Frauenklinik, Landeskliniken Salzburg, Müllner Hauptstraße 48, 5020 Salzburg, Austria, Austria aut NATIONALLICENCE 700 1- Waclawiczek H. W. I. Chirurgische Abteilung und Ludwig-Boltzmann-Institut für experimentelle und gastroenterologische Chirurgie, Landeskliniken Salzburg, Müllner Hauptstraße 48, 5020 Salzburg, Austria, Austria aut NATIONALLICENCE 700 1- Holzinger J. I. Chirurgische Abteilung und Ludwig-Boltzmann-Institut für experimentelle und gastroenterologische Chirurgie, Landeskliniken Salzburg, Müllner Hauptstraße 48, 5020 Salzburg, Austria, Austria aut NATIONALLICENCE 700 1- Mayer F. I. Chirurgische Abteilung und Ludwig-Boltzmann-Institut für experimentelle und gastroenterologische Chirurgie, Landeskliniken Salzburg, Müllner Hauptstraße 48, 5020 Salzburg, Austria, Austria aut NATIONALLICENCE 700 1- Heuberger A. II. Chirurgische Abteilung, Landeskliniken Salzburg, A-5020 Salzburg, Austria, Austria aut NATIONALLICENCE 700 1- Boeckl O. I. Chirurgische Abteilung und Ludwig-Boltzmann-Institut für experimentelle und gastroenterologische Chirurgie, Landeskliniken Salzburg, Müllner Hauptstraße 48, 5020 Salzburg, Austria, Austria aut NATIONALLICENCE 773 0- Surgical Endoscopy Springer-Verlag 14/3(2000-03-01), 267-271 0930-2794 14:3<267 2000 14 464 Metadata rights reserved Springer special CC-BY-NC licence nationallicence BK010053 XK010053 XK010000 NATIONALLICENCE NATIONALLICENCE NL-springer