Surgical considerations in the contemporary management of biliary tract disease in the postpartum period
| Autor: | Gerald Kaplan, Nancy A. Diettrich |
|---|---|
| Rok vydání: | 1998 |
| Předmět: |
Adult
medicine.medical_specialty Adolescent Gallstones Cholangiography Pneumoperitoneum Pregnancy Humans Medicine Prospective Studies Cholangiopancreatography Endoscopic Retrograde medicine.diagnostic_test business.industry Postpartum Period General Medicine Delivery Obstetric medicine.disease Surgery Cholecystectomy Laparoscopic Sterilization (medicine) Biliary tract Cholecystitis Female business Complication Pneumoperitoneum Artificial Postpartum period Follow-Up Studies Cohort study |
| Zdroj: | The American Journal of Surgery. 176:251-253 |
| ISSN: | 0002-9610 |
| DOI: | 10.1016/s0002-9610(98)00153-6 |
| Popis: | Background: Excluding sterilization procedures, no experience with laparoscopic procedures in the postpartum period has been reported. The postpartum patient may have unique characteristics that must be recognized for safe management. Methods: The authors prospectively studied 1,100 consecutive biliary patients in a private surgical practice since the introduction of laparoscopic cholecystectomy (LC). The group includes 34 patients who presented with biliary tract disease and were operated upon within 6 weeks of obstetrical delivery. Laparoscopic procedures were performed on these 34 patients 1 to 42 days following vaginal (26) or Cesarean (8) deliveries. Results: All patients had calculous cholecystitis. Choledocholithiasis was documented in 10 (29%) patients, including 3 patients (9%) with missed common duct stones, and strongly suggested in 5 (15%) others. Open biliary procedures were required for 2 patients. One patient returned to surgery for an ERCP-related complication. Follow up is known for all patients. There were no delayed complications. Conclusions: The laparoscopic approach to biliary tract disease in the postpartum period is safe. Recent vertical Cesarean incisions can withstand the strain of a reduced pneumoperitoneum. The high incidence of choledocholithiasis calls for routine cholangiography in the postpartum patient. |
| Databáze: | OpenAIRE |
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