Work

Laparoscopic management of cholelithiasis with choledocholithiasis in pregnancy: a case report

Year: 2025

Type: article

Abstract: Introduction and Importance: Choledocholithiasis during pregnancy is uncommon but potentially life-threatening for both mother and fetus if complications arise. Management poses unique challenges due to physiological and anatomical changes in pregnancy and concerns for fetal safety. Although laparoscopic approaches are generally well accepted, evidence guiding optimal management remains limited. Current guidelines on choledocholithiasis in pregnancy remain inconsistent due to limited evidence, and recommendations often emphasize individualized care depending on gestational age, symptom severity, and institutional expertise. Case Presentation: A 26-year-old pregnant woman at 21 weeks of gestation with a history of spontaneous abortion presented with right upper quadrant pain and nausea. Diagnosed with choledocholithiasis, she underwent laparoscopic common bile duct exploration (LCBDE) with laparoscopic cholecystectomy (LC). Surgery was successful, and the patient recovered well postoperatively, with normal fetal activity and no complications. The patient delivered a healthy male child weighing 3.2 kg at 38 weeks of gestation via lower segment cesarean section, with no morbidity or teratogenic effects observed. Clinical Discussion: This case report discusses the management of a pregnant patient in the second trimester who underwent single-stage LCBDE and LC for choledocholithiasis and cholelithiasis. We highlight key considerations, including perioperative monitoring, anesthetic modifications, and surgical techniques to ensure maternal and fetal well-being. Laparoscopic approach reduces postoperative morbidity, shortens recovery time, and minimizes fetal risks. The patient had an uneventful recovery, with favorable maternal and fetal outcomes. Conclusion: This case report reinforces the feasibility and safety of laparoscopic approach to choledocholithiasis and cholelithiasis during the second trimester pregnancy.

Source: Annals of Medicine and Surgery

DOI: 10.1097/ms9.0000000000004077

Authors: Ashish Bhatta, Krisha Maharjan, Aayush Bist, Tanka Prasad Bohora, Mukund Raj Joshi

Institutions: KIST Medical College, Nepal Medical College Teaching Hospital

Language: English

Topic: Gallbladder and Bile Duct Disorders

Subfield: Pulmonary and Respiratory Medicine

Field: Medicine

Domain: Health Sciences

SDG: Good health and well-being

Open Access status: gold

Estimated APC paid: $1,850