Favorable Strategy for Gall Stone Disease in Second Tremester of Pregnancy^|^mdash;A Case Report^|^mdash;

Abstract

Symptomatic gallstone disease is the second most common abdominal emergency in pregnant women next to acute appendicitis. A 27-year-old woman who had been medicated for diabetes mellitus presented with several episodes of epigastric pain in the 21st week of gestation. Abdominal ultrasonography showed a stone in the neck of the gallbladder. Conservative therapy succeeded in controlling billiary colic, but she could not take meals because oral ingestion caused the onset of colic. Total parental nutrition until the third trimester was likely to entail a risk of intrauterine growth restriction. We performed laparoscopic cholecystectomy in the 24th week of gestation. Para- and post-operative course was uneventful and she labored a baby 2,824g in body weight in the 40th week. Because of a high incidence of failure of the con- servative therapy and easy recurrence of the symptoms during pregnancy, laparoscopic cholecystectomy should be offered to symptomatic gallstone disease patients during the second trimester when compara- tively