The laparoscopic management of appendicitis and cholelithiasis during pregnancy.
BACKGROUND
Laparoscopic management of appendicitis and symptomatic cholelithiasis during pregnancy remains controversial. We report the single largest series of laparoscopic cholecystectomies and appendectomies during pregnancy.


METHODS
Medical records of all pregnant patients who underwent open or laparoscopic management of appendicitis/cholelithiasis at LDS Hospital from 1990 to 1998 were reviewed.


RESULTS
Eighteen open appendectomies (OA) and 13 open cholecystectomies (OC) were performed. Forty-five laparoscopic cholecystectomies (LC) and 22 laparoscopic appendectomies (LA) were performed without birth defects, fetal loss or uterine injury. Preterm delivery rates (PTD) in the LA and OA groups were similar (15.8% versus 11.8%, P>0.9). The PTD rate in the LC group was not significantly different than in the OC group (11.9% versus 10.0%, P>0.9). Neither birth weights nor Apgar scores were significantly different across groups.


CONCLUSIONS
Laparoscopic management of appendicitis and symptomatic cholelithiasis during pregnancy can be performed with minimal fetal and maternal morbidity when accepted management guidelines are followed.
Affleck
D G
DG
Latter-day Saints, Hospital Department of Surgery, Salt Lake City, Utah 84102, USA.
Handrahan
D L
DL
Egger
M J
MJ
Price
R R
RR
D000328:Adult; D001062:Appendectomy / Q000379:methods* / Q000706:statistics & numerical data; D001064:Appendicitis / Q000453:epidemiology / Q000601:surgery*; D017081:Cholecystectomy, Laparoscopic / Q000706:statistics & numerical data; D002769:Cholelithiasis / Q000453:epidemiology / Q000601:surgery*; D000013:Congenital Abnormalities / Q000453:epidemiology; D005260:Female; D005315:Fetal Diseases / Q000453:epidemiology; D006801:Humans; D010535:Laparoscopy / Q000706:statistics & numerical data; D007752:Obstetric Labor, Premature / Q000453:epidemiology; D011247:Pregnancy; D011248:Pregnancy Complications / Q000453:epidemiology / Q000601:surgery*