| Abstrakt: |
Background: Cholecystitis during pregnancy poses a significant medical challenge, necessitating a careful examination of optimal management strategies. This multi-center comparative study investigates the efficacy and safety of interval cholecystectomy versus early cholecystectomy for obstetric cholecystitis, encompassing both antenatal and postpartum periods. The study focuses on women aged 22 to 35 years, aiming to provide comprehensive insights into the outcomes associated with these surgical approaches. Materials and Methods: This multi-center study involves a diverse cohort of women aged 22 to 35 years, diagnosed with obstetric cholecystitis. The participants will be recruited from Karpagam faculty of medical sciences and research, Nalan Gastro Centre and One care medical centre, Karpagam, Coimbatore, ensuring a representative sample reflecting the broader population. Patients will be randomly assigned to either the early cholecystectomy group or the interval cholecystectomy group. Baseline characteristics, including age, gestational age, and medical history, will be recorded. The primary outcome measures include surgical complications, maternal morbidity, and fetal outcomes. For antenatal cholecystitis, participants in the early cholecystectomy group will undergo surgery during pregnancy, while those in the interval cholecystectomy group will receive conservative management initially, with surgery scheduled postpartum. In the postpartum cholecystitis arm, early cholecystectomy will be performed within the first few days after delivery, while the interval cholecystectomy group will receive conservative management initially, with surgery scheduled at a later postpartum period. Data will be collected regarding the incidence of complications such as preterm labor, fetal distress, and maternal complications. Surgical outcomes, including operative time, blood loss, and postoperative recovery, will be meticulously documented. Results: Preliminary analysis reveals that both early and interval cholecystectomy demonstrates favorable outcomes in terms of maternal and fetal well-being. The early cholecystectomy group exhibits a lower incidence of acute complications during pregnancy, such as preterm labor and fetal distress, suggesting that timely surgical intervention may mitigate the progression of the disease. On the other hand, the interval cholecystectomy group demonstrates a lower overall incidence of surgical complications, emphasizing the safety of delaying surgery until after delivery. This group also shows a reduced rate of postoperative morbidity, indicating that deferring cholecystectomy does not compromise maternal health. Operative times are comparable between the two groups, dispelling concerns regarding prolonged surgery during pregnancy. Blood loss is also within acceptable limits for both cohorts. Postoperative recovery is generally uneventful, with no significant differences observed in terms of hospital stay and time to return to normal activities. Conclusion: In conclusion the findings suggest that early cholecystectomy may be particularly beneficial in reducing acute complications during pregnancy, providing a timely resolution to the inflammatory process. On the other hand, interval cholecystectomy appears to be a safe alternative, avoiding surgery during pregnancy and demonstrating favorable postoperative outcomes. [ABSTRACT FROM AUTHOR] |
