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Medline ® Abstract for Reference 43

of 'Gallstones in pregnancy'

Biliary disease during pregnancy.
Swisher SG, Schmit PJ, Hunt KK, Hiyama DT, Bennion RS, Swisher EM, Thompson JE
Am J Surg. 1994;168(6):576.
BACKGROUND: Biliary disease during pregnancy is rare and the need for surgery in these cases is controversial. We evaluated our experience with biliary disease during pregnancy with regard to outcome and cost containment.
PATIENTS AND METHODS: We reviewed the clinical course of pregnant women with biliary disease at the University of California at Los Angeles and Olive View-UCLA Medical Centers from 1988 to 1993.
RESULTS: Seventy-two of 46,075 pregnant women presented with biliary disease (incidence 0.16%). Sixteen underwent surgery while pregnant, 5 in the first and 11 in the second trimester. No maternal or fetal deaths occurred secondary to medical or surgical management of biliary disease. Patients who were treated medically at initial presentation had a 69% rate of relapse prior to delivery, compared to no relapses in those treated surgically (P<0.01). Patients who experienced relapse spent an average of 3.0 additional days in hospital.
CONCLUSION: Surgical therapy for biliary disease performed in the second trimester of pregnancy doesnot increase morbidity and may help reduce relapses and additional days in hospital.
Department of Surgery, University of California School of Medicine, Los Angeles.