ABSTRACT
Twenty-seven pregnant women, with symptomatic gallstone disease, were admitted to this prospective study. All patients received initial medical therapy, and surgical intervention was performed in cases with frequent relapses or no response to medical treatment. Twelve patients underwent surgery during pregnancy, 2 in the first and 10 in the second trimester. Eight patients underwent laparoscopic cholecystectomy, while 4 had open cholecystectomy [one had exploration of the common bile duct]. While no maternal or fetal deaths occurred secondary to medical treatment, one spontaneous abortion occurred following open cholecystectomy in the first trimester. Patients, after receiving primary medical treatment, had 74.1% rate of relapse and additional days in hospital, compared to no relapse and less hospital stays after surgery. Patients acute cholecystitis had increased incidence of medical treatment failure and need of surgery. It is concluded that management of biliary tract disease during pregnancy should follow a protocol, with clear indications for the role of surgical intervention during the second trimester of pregnancy does not increase maternal or fetal morbidity. It may in fact reduce the number of relapses during pregnancy, hence reduces the consequent complications and additional hospital stay. Laparoscopic cholecystectomy is feasible in the great majority of patients, except those with large uteri in the late second trimester and the presence of common bile duct stones