title: Major hepatobiliary surgery during pregnancy: safety and timing.
abstract: Hepatobiliary disease, although rare, may present during pregnancy with potential complications for mother and fetus. We present two cases of choledochal cysts and one case of a hepatic adenoma diagnosed in gravid patients. All three patients had acute events or failed medical management and were successfully treated with open resection, excision, or reconstruction during the second or third trimesters of pregnancy without requiring blood transfusions or tocolytic therapy. Although conservative treatment may be indicated in select patients due to the risk of underlying disease, we recommend surgical treatment preferably in the second trimester. With diligent intra- and postoperative management, pregnant patients can safely proceed with major hepatobiliary surgery.
authors.affiliation: Division of Hepatobiliary/Pancreatic Surgery and Transplant Surgery, University of Southern California-University Hospital, Los Angeles, California 90033, USA.
authors.forename: Nicolas
authors.initials: N
authors.lastname: Jabbour
authors.forename: Megan
authors.initials: M
authors.lastname: Brenner
authors.forename: Singh
authors.initials: S
authors.lastname: Gagandeep
authors.forename: Abe
authors.initials: A
authors.lastname: Lin
authors.forename: Yuri
authors.initials: Y
authors.lastname: Genyk
authors.forename: Rick
authors.initials: R
authors.lastname: Selby
authors.forename: Rodrigo
authors.initials: R
authors.lastname: Mateo
mesh_terms: D018248:Adenoma, Liver Cell / Q000175:diagnosis / Q000601:surgery*; D000328:Adult; D049448:Cholangiopancreatography, Magnetic Resonance; D002763:Cholecystectomy; D015529:Choledochal Cyst / Q000175:diagnosis / Q000601:surgery*; D005260:Female; D005500:Follow-Up Studies; D006498:Hepatectomy; D006801:Humans; D008113:Liver Neoplasms / Q000175:diagnosis / Q000601:surgery*; D011247:Pregnancy; D011248:Pregnancy Complications; D012189:Retrospective Studies; D012449:Safety; D013997:Time Factors; D014057:Tomography, X-Ray Computed