Cholecystectomy of the Pregnant Patient

Gallbladder disease (GD) is a wide spectrum of disorders of the gallbladder and biliary tract. Complicated GD (CGD; cholecystitis, cholangitis, gallstone pancreatitis) is the third most common cause of rehospitalization within 60 days of delivery. Symptoms of GD include right upper quadrant (RUQ) pain, fever, nausea, and ill appearance. Ultrasound is considered first line as part of the workup for suspected GD disease. Although cholecystectomy may be performed via open or laparoscopic approaches depending on surgeon preference and experience, laparoscopic cholecystectomy is safe and effective at treating GD during pregnancy and may decrease the frequency of antepartum and postpartum admissions of affected patient. Therefore, practitioners should have a low threshold to recommend surgical intervention. Multiple strategies may be employed to reduce the risk of cholecystectomy performed during pregnancy.