Safety of ERCP during pregnancy.
Am J Gastroenterol
; 98(2): 308-11, 2003 Feb.
Article
en En
| MEDLINE
| ID: mdl-12591046
ABSTRACT
OBJECTIVES:
There are few data in the literature regarding the indications, therapy, and safety of endoscopic management of pancreatico-biliary disorders during pregnancy. We report the largest single center experience with ERCP in pregnancy.METHODS:
We reviewed 15 patients that underwent ERCP during pregnancy. In all patients, the pelvis was lead-shielded and the fetus was monitored by an obstetrician. Fluoroscopy was minimized and hard copy radiographs taken only when essential.RESULTS:
The mean patient age was 28.9 yr (15-36 yr). The mean duration of gestation was 25 wk (12-33 wk); one patient was in the first, five in the second, and nine in the third trimester. The indications were gallstone pancreatitis (n = 6), choledocholithiasis on ultrasound (n = 5), elevated liver enzymes and a dilated bile duct on ultrasound (n = 2), abdominal pain and gallstones (n = 1), and chronic pancreatitis (n = 1). ERCP findings were bile duct stones (n = 6), patulous papilla (n = 1), bile duct debris (n = 1), normal bile duct and gallstones or gallbladder sludge (n = 3), dilated bile duct and gallstones (n = 1), normal bile duct and no gallstones (n = 2), and chronic pancreatitis (n = 1). Six patients underwent sphincterotomies and one a biliary stent insertion. One sphincterotomy was complicated by mild pancreatitis. All infants delivered to date have had Apgar-scores >8, and continuing pregnancies are uneventful. Mean fluorosocopy time was 3.2 min (SD +/- 1.8). An estimated fetal radiation exposure was 310 mrad (SD +/- 164) which is substantially below the accepted teratogenic dose.CONCLUSIONS:
ERCP in pregnancy seems to be safe for both mother and fetus; however, it should be restricted to therapeutic indications with additional intraprocedure safety measures.
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Colección:
01-internacional
Base de datos:
MEDLINE
Asunto principal:
Enfermedades Pancreáticas
/
Complicaciones del Embarazo
/
Enfermedades de las Vías Biliares
/
Colangiopancreatografia Retrógrada Endoscópica
Límite:
Adult
/
Female
/
Humans
/
Pregnancy
Idioma:
En
Revista:
Am J Gastroenterol
Año:
2003
Tipo del documento:
Article
País de afiliación:
Estados Unidos