Considering delay of cholecystectomy in the third trimester of pregnancy
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and Other Interventional Techniques
2020 SAGES ORAL
Considering delay of cholecystectomy in the third trimester of pregnancy Julie Hong1 · Jie Yang2 · Xiaoyue Zhang2 · Jared Su1 · Abhinay Tumati1 · David Garry3 · Salvatore Docimo1 · Andrew T. Bates1 · Konstantinos Spaniolas1 · Mark A. Talamini1 · Aurora D. Pryor1 Received: 6 April 2020 / Accepted: 17 August 2020 © Springer Science+Business Media, LLC, part of Springer Nature 2020
Abstract Introduction Current guidelines support laparoscopic cholecystectomy as the treatment of choice for pregnant women with symptomatic gallbladder disease, regardless of the trimester. Early intervention has remained the standard of care, but recent evidence has challenged this practice in pregnant women. We sought to compare surgical and maternal–fetal outcomes of antepartum versus postpartum cholecystectomy in New York State. Methods Between 2005 and 2014, the New York Statewide Planning and Research Cooperative System (SPARCS) database was queried for patients who underwent cholecystectomy within 3 months before (antepartum cholecystectomy, APCCY: n = 82) and after (postpartum cholecystectomy, PPCCY: n = 5040) childbirth to approximate third-trimester operations. All patients who underwent cholecystectomy during pregnancy (n = 971) were extracted to evaluate inter-trimester differences. Subgroup analysis compared APCCY patients who were not hospitalized within 1 year before APCCY (n = 80) and PPCCY patients who were hospitalized within 1 year before childbirth (n = 29) for symptomatic biliary disease. Multivariable generalized linear regression models were used to characterize the association between timing of cholecystectomy and several primary outcomes: length of stay (LOS), 30-day non-pregnancy, non-delivery readmission (NPND), bile duct injury (BDI), composite maternal outcome (antepartum hemorrhage, preterm delivery, cesarean section), any complications, and fetal demise. Results Third-trimester APCCY women had longer LOS (Ratio: 1.44, 95% CI [1.26–1.66], p
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