Course and outcomes of complicated gallstone disease in pregnancy: a single centre experience


  • Nihida Akhter Department of Obstetrics and Gynecology, GMC Srinagar, Jammu and Kashmir, India
  • Irfan Nazir Mir Department of Surgery, GMC Srinagar, Jammu and Kashmir, India
  • Sheikh Viqar Manzoor Department of Surgery, GMC Srinagar, Jammu and Kashmir, India



Cholecystitis, Endoscopic retrograde cholangiopancreatography, Low birth weight, Ultrasonography


Background: The incidence of acute abdomen during pregnancy is approximately 1 in 500 pregnancies. The incidence of symptomatic gallstone disease in pregnancy is reported in approximately 0.2-0.5 per 1,000 pregnancies. Symptoms are similar to those in the nonpregnant state. A delay in diagnosis may increase the risk of perforation. Treatment in most cases is conservative. However, recent trends, newer instrumentation and skilled personnel encourage arranging laparoscopic cholecystectomy at the time of diagnosis.

Methods: This study was a retrospective study, included 117 pregnant patients with acute gallstone disease, who were treated and followed-up at Government Medical College, Srinagar, Department of General Surgery and Department of Gynae And Obstetrics, between January 2015 and April 2017.

Results: The mean age of patients in our study was 28.6 years. Majority of patients 56 (47.86%) were in is trimester of pregnancy. Parity of the patients varied from 1 to 6, with a mean parity of 2.67. The presentation of majority of patients was colicky pain right upper abdomen,108 (92.30%). All patients had gallstones on USG scan.101(86.32%) patients had acute cholecystitis, while 8 (6.83%) patients had predominant features of acute pancreatitis,8(6.83%) patients had accompanying choledocholithiasis The average wall thickness of gallbladder in our patients was 4.62 mm. Majority 106 (90.59%) patients were managed conservatively. 8 (6.83%) patients underwent cholecystectomy in same admission, after failure of conservative management, 7 patients underwent laparoscopic cholecystectomy and one underwent open cholecystectomy. 3 patients (2.56%), who had features of cholangitis were managed by ERCP. The average length of hospital stay in our patient group was 8.61 days. There was one maternal death reported in our study, there were a total of 8 (6.83%) preterm deliveries.

Conclusions: Symptomatic gallstone disease in pregnancy is a common surgical problem. Diagnosis during pregnancy can be difficult, majority of cases can be managed conservatively, intervention whenever indicated must be undertaken.


Coleman MT, Trianfo VA, Rund DA. Nonobstetric emergencies in pregnancy: trauma and surgical conditions. Am J Obs Gynecol. 1997;177(3):497-502.

Benjaminov FS, Heathcote J. Liver disease in pregnancy. Am J Gastroenterol. 2004;99:2479-88.

Van Thiel DH, Gavaler JS. Pregnancy-associated sex steroids and their effects on the liver. Seminars Liver Disease. 1987;7(01):1-7.

Landers DA, Carmona RI, Crombleholme WI, Lim RO. Acute cholecystitis in pregnancy. Obs Gynecol. 1987;69(1):131-3.

Allmendinger N, Hallisey MJ, Ohki SK, Straub JJ. Percutaneous cholecystostomy treatment of acute cholecystitis in pregnancy. Obs Gynecol. 1995;86(4):653-4.

Baillie J. ERCP during pregnancy. Am J Gastroenterol. 2003;98:237-8.

Halkic N, Tempia-Caliera AA, Ksontini R, Suter M, Delaloye JF, Vuilleumier H. Laparoscopic management of appendicitis and symptomatic cholelithiasis during pregnancy. Langenbeck's Arch Surg. 2006;391(5):467-71.

Angelini DJ. Obstetric triage: management of acute nonobstetric abdominal pain in pregnancy. J Nurse-Mid. 1999;44(6):572-84.

Augustin G, Majerovic M. Non-obstetrical acute abdomen during pregnancy. European J Obs Gynecol Repro Bio. 2007;131(1):4-12.

Barone JE, Bears S, Chen S, Tsai J, Russell JC. Outcome study of cholecystectomy during pregnancy. Am J Surg. 1999;177(3):232-6.

Ghumman E, Barry M, Grace PA. Management of gallstones in pregnancy. Brit J Surg. 1997;84(12):1646-50.

Mohammed AA, Alam MK, Iweze F, Al-Arifi FS, Qazi S. Laparoscopic cholecystectomy: initial experience at Riyadh Central Hospital. Ann Saudi Med. 1993;13(4):360-4.

Lonzafame RJ. Laparoscopic cholecystectomy. Surg. 1995;118:627-31.

Sungler P, Heinerman PM, Steiner H, Waclawiczek HW, Holzinger J, Mayer F, et al. Laparoscopic cholecystectomy and interventional endoscopy for gallstone complications during pregnancy. Surg Endosc. 2000;14(3):267-71.

Scott LD. Gallstone disease and pancreatitis in pregnancy. Gastroenterol Clin North Am. 1992;21(4):803-15.

Dixon NP, Faddis DM, Silberman H. Aggressive management of cholecystitis during pregnancy. Am J Surg. 1987;154(3):292-4.

Cosenza CA, Saffari B, Jabbour N, Stain SC, Garry D, Parekh D, et al. Surgical management of biliary gallstone disease during pregnancy. Am J Surg. 1999;178(6):545-8.




How to Cite

Akhter, N., Mir, I. N., & Manzoor, S. V. (2019). Course and outcomes of complicated gallstone disease in pregnancy: a single centre experience. International Journal of Research in Medical Sciences, 7(7), 2686–2689.



Original Research Articles